title: A phase I-II study of high-dose melphalan, mitoxantrone and carboplatin with peripheral blood stem cell support in patients with advanced ovarian or breast carcinoma.
abstract: The purpose of this study was to develop a high-dose chemotherapy (HDC) and peripheral blood stem cell (PBSC) regimen for treatment of patients with ovarian carcinoma that could be administered in an outpatient setting. Fourteen patients with advanced ovarian (n = 9) or breast (n = 5) carcinoma, who had failed conventional chemotherapy, were entered into a dose-escalation trial to determine the maximum tolerated dose (MTD) of carboplatin that could be administered with fixed doses of melphalan (160 mg/m2) and mitoxantrone (50 mg/m2). Twenty-five additional patients were included in a phase II trial at the MTD. Two of two patients had grade 4 severe regimen-related toxicities (RRT), one fatal, at a dose level of 1600 mg/m2. Two of 29 patients (6.9%) treated at the MTD (carboplatin, 1400 mg/m2) died of RRT. All three patients who died of toxicity had a calculated AUC for carboplatin >30 mg/ml/min. Thirty-one patients with ovarian cancer who had failed chemotherapy were treated, 24 at the MTD. Fourteen of 20 patients (70%) with ovarian carcinoma with evaluable disease achieved a CR and seven (35%) are alive disease-free a median of 20 months (range, 7-26). Five of seven patients with ovarian cancer who had failed chemotherapy but were rendered clinically disease-free following surgery survive without progression a median of 13 months (range, 9-19). Eight of 16 (50%) platinum-resistant and 4/12 (33%) platinum-sensitive patients with ovarian cancer survive disease-free.
authors.affiliation: Clinical Research Division of Response Oncology, Inc., Memphis, TN, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Weaver
authors.forename: F A
authors.initials: FA
authors.lastname: Greco
authors.forename: J D
authors.initials: JD
authors.lastname: Hainsworth
authors.forename: B
authors.initials: B
authors.lastname: Zhen
authors.forename: P
authors.initials: P
authors.lastname: Baldwin
authors.forename: F
authors.initials: F
authors.lastname: Wittlin
authors.forename: M
authors.initials: M
authors.lastname: Lewis
authors.forename: W H
authors.initials: WH
authors.lastname: West
authors.forename: L
authors.initials: L
authors.lastname: Schwartzberg
authors.forename: C D
authors.initials: CD
authors.lastname: Buckner
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001855:Bone Marrow Diseases / Q000139:chemically induced / Q000628:therapy; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000139:chemically induced; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015993:Life Tables; D017563:Lung Diseases, Interstitial / Q000139:chemically induced; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage / Q000009:adverse effects; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D051437:Renal Insufficiency / Q000139:chemically induced; D016879:Salvage Therapy; D016896:Treatment Outcome
chemical_list: D016190:Carboplatin; D008942:Mitoxantrone; D008558:Melphalan