title: High-dose busulfan, melphalan and thiotepa followed by autologous peripheral blood stem cell (PBSC) rescue in patients with advanced stage III/IV ovarian cancer.
abstract: The purpose of this study was to evaluate the efficacy of high-dose chemotherapy (HDC) with busulfan, melphalan and thiotepa (BUMELTT) followed by autologous PBSC infusion in treating patients with advanced ovarian cancer. Thirty-one patients, 18 with stage III/IIIc and 13 with stage IV ovarian cancer, were treated with BU (12 mg/kg), MEL (100 mg/m2) and TT (500 mg/m2) and autologous PBSC rescue. Fifteen patients were in clinical complete remission (CR) at treatment; 11 had platinum-sensitive disease. Sixteen patients were not in CR; two had platinum-sensitive disease. The probabilities of overall survival (OS), event-free survival (EFS) and relapse (R) for all patients at 18 months were 0.57, 0.30 and 0.63; for patients in CR, the rates were 0.87, 0.44 and 0.49 and for patients not in CR, 0.38, 0.13 and 0.81. Two patients (6.5%) died of treatment-related causes. Among the 13 patients with platinum-sensitive disease, all are still alive, with seven having relapsed 129-1021 days after PBSC infusion. OS, EFS and R were 1.00, 0.52 and 0.48. Of the 18 patients with platinum-resistant disease, four remain alive (two in remission). Six patients did not respond and eight relapsed from days 104-429. The OS, EFS and R were 0.33, 0.11 and 0.78. We conclude that BUMELTT is well tolerated in patients with advanced ovarian cancer and results are equivalent to other published HDC regimens.
authors.affiliation: Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Puget Sound Oncology Consortium, Seattle 98109-1024, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Holmberg
authors.forename: T
authors.initials: T
authors.lastname: Demirer
authors.forename: S
authors.initials: S
authors.lastname: Rowley
authors.forename: C D
authors.initials: CD
authors.lastname: Buckner
authors.forename: G
authors.initials: G
authors.lastname: Goodman
authors.forename: R
authors.initials: R
authors.lastname: Maziarz
authors.forename: J
authors.initials: J
authors.lastname: Klarnet
authors.forename: N
authors.initials: N
authors.lastname: Zuckerman
authors.forename: G
authors.initials: G
authors.lastname: Harrer
authors.forename: R
authors.initials: R
authors.lastname: McCloskey
authors.forename: R
authors.initials: R
authors.lastname: Gersh
authors.forename: R
authors.initials: R
authors.lastname: Goldberg
authors.forename: W
authors.initials: W
authors.lastname: Nichols
authors.forename: A
authors.initials: A
authors.lastname: Jacobs
authors.forename: P
authors.initials: P
authors.lastname: Weiden
authors.forename: P
authors.initials: P
authors.lastname: Montgomery
authors.forename: S
authors.initials: S
authors.lastname: Rivkin
authors.forename: F R
authors.initials: FR
authors.lastname: Appelbaum
authors.forename: W I
authors.initials: WI
authors.lastname: Bensinger
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002066:Busulfan / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008558:Melphalan / Q000008:administration & dosage*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology / Q000628:therapy*; D013852:Thiotepa / Q000008:administration & dosage*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D013852:Thiotepa; D002066:Busulfan; D008558:Melphalan