title: Phase II trial of methotrexate, vinblastine, doxorubicin, and cisplatin in advanced/recurrent endometrial carcinoma.
abstract: A phase II combination chemotherapy protocol combining methotrexate, vinblastine, doxorubicin, and cisplatin was designed to evaluate tumor response and survival in patients with advanced/recurrent endometrial carcinoma. Thirty patients with advanced/recurrent endometrial carcinoma were assigned to chemotherapy treatment at 4-week intervals with methotrexate 30 mg/m2 i.v. Days 1, 15, and 22; vinblastine 3 mg/m2 i.v. Days 2, 15, and 22; doxorubicin 30 mg/m2 i.v. Day 2; and cisplatin 70 mg/m2 i.v. Day 2. After a median of four cycles (maximum number two cycles beyond complete regression; minimum six cycles for stable partial regression), we observed objective regression in 20 patients (67%) (95% CI, 50, 84) with complete regression in 8 patients (27%) and partial regression in 12 patients (40%). Median overall survival was 9.9 months (range, 0.3-34.2), and median survival of responders was 11.0 months (range, 2.6-34.2) from initial date of response. Toxicity was substantial with two treatment-related deaths and consisted predominantly of neutropenia (grade 3 or greater in 93% of the patients), alopecia, nausea, emesis, stomatitis, and azotemia. In conclusion, MVAC is a highly active outpatient chemotherapy regimen in patients with advanced/recurrent endometrial carcinoma, achieving a high complete and partial response rate. Toxicity is substantial in this elderly patient population.
authors.affiliation: Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: H J
authors.initials: HJ
authors.lastname: Long
authors.forename: R M
authors.initials: RM
authors.lastname: Langdon
authors.forename: S S
authors.initials: SS
authors.lastname: Cha
authors.forename: M H
authors.initials: MH
authors.lastname: Veeder
authors.forename: D M
authors.initials: DM
authors.lastname: Pfeifle
authors.forename: J E
authors.initials: JE
authors.lastname: Krook
authors.forename: L P
authors.initials: LP
authors.lastname: Ebbert
authors.forename: L K
authors.initials: LK
authors.lastname: Tschetter
authors.forename: S G
authors.initials: SG
authors.lastname: Roshon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D016889:Endometrial Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D014747:Vinblastine; D004317:Doxorubicin; D002945:Cisplatin; D008727:Methotrexate