Intraperitoneal carboplatin: favorable results in women with minimal residual ovarian cancer after cisplatin therapy.
From August 1985 to November 1989 we conducted a trial of intraperitoneal (IP) carboplatin including a dose-escalation design in 25 women with advanced gynecologic malignancies. All had extensive prior therapy with cisplatin (median cumulative dose, 525 mg/m2). Carboplatin was administered IP in 2 L of 1.5% dextrose with a 4-hour dwell time every 4 weeks for six cycles at a starting dose of 200 mg/m2. Patients with reduced creatinine clearance (30 to 60 cc/min) were escalated more slowly than those with high (greater than 60 cc/min) clearance. Thrombocytopenia was dose-limiting and often more severe in patients with compromised renal function; there was no local drug toxicity. The median time of follow-up is 25 months. Complete responses (CRs) were documented in six of 23 assessable patients (26%) by repeat laparotomy, and an additional 11 patients (48%) had no disease evident by noninvasive restaging. Five of the CRs and six of the patients with no clinically evident disease have relapsed from 3 to 40 months after therapy. Six patients (26%) are alive and free of disease 8 to 47 (median, 20) months after therapy. IP carboplatin is effective against relapsed ovarian cancer, even after prior cisplatin therapy.
Speyer
J L
JL
Rita and Stanley H. Kaplan Cancer Center, Department of Medicine, New York University Medical Center.
Beller
U
U
Colombo
N
N
Sorich
J
J
Wernz
J C
JC
Hochster
H
H
Green
M
M
Porges
R
R
Muggia
F M
FM
Canetta
R
R
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin; D002945:Cisplatin / Q000627:therapeutic use*; D003404:Creatinine / Q000378:metabolism; D004341:Drug Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007263:Infusions, Parenteral; D007668:Kidney / Q000503:physiopathology; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D010529:Peritoneal Cavity; D012074:Remission Induction; D015996:Survival Rate; D013921:Thrombocytopenia / Q000139:chemically induced
D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D003404:Creatinine; D016190:Carboplatin; D002945:Cisplatin