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.
Rita and Stanley H. Kaplan Cancer Center, Department of Medicine, New York University Medical Center.
J L
JL
Speyer
U
U
Beller
N
N
Colombo
J
J
Sorich
J C
JC
Wernz
H
H
Hochster
M
M
Green
R
R
Porges
F M
FM
Muggia
R
R
Canetta
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