title: A phase I study of paclitaxel and epirubicin, without and with filgrastim, for the treatment of platinum-resistant advanced ovarian cancer.
abstract: The aim of the study was to determine the maximum tolerated dose (MTD) of epirubicin combined with a fixed dose of paclitaxel, without and with support of filgrastim, in patients with platinum resistant or refractory ovarian cancer. Paclitaxel (150 mg/m2) and epirubicin (starting dose 90 mg/m2, 15 mg/m2 escalation per level) were given on day 1, every 28 days for 4-6 cycles. Filgrastim (F) (5 microg/kg/die) was given in case of grade 4 leukopenia (levels without support) or from day 4 up to leukocyte count >10,000/mm3 after nadir (levels with support). Cohorts of 3 patients were enrolled at each level and further 3 patients were planned if 1 or 2 unacceptable toxic events (UTE) were registered. MTD was determined first without and then with filgrastim. Four levels were studied (90, 90+F, 105+F, 120+F) with 4, 6, 5 and 4 patients enrolled, respectively. UTE (grade 4 neutropenia) were observed in 3 patients at level 1. Thus, 90 mg/m2 was the MTD for epirubicin without filgrastim. MTD of epirubicin with filgrastim was not reached at 120 mg/m2. Hematological toxicity was mild. Grade 3 mucositis was reported in 1 patient. Among the 14 patients with measurable or evaluable disease, 3 objective responses were observed (1 complete and 2 partial) for an overall response rate of 21.4%. The combination of paclitaxel 150 mg/m2 and epirubicin at 120 mg/m2 with filgrastim is a feasible therapy. Grade 4 leukopenia is the dose limiting toxicity using epirubicin at 90 mg/m2 without filgrastim.
authors.affiliation: Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Facoltà di Medicina e Chirurgia, Università Federico II, Napoli, Italia.
authors.forename: R
authors.initials: R
authors.lastname: Lauria
authors.forename: E
authors.initials: E
authors.lastname: Ferrari
authors.forename: S
authors.initials: S
authors.lastname: Tramontana
authors.forename: A
authors.initials: A
authors.lastname: Morabito
authors.forename: F
authors.initials: F
authors.lastname: Perrone
authors.forename: A
authors.initials: A
authors.lastname: Maffeo
authors.forename: R
authors.initials: R
authors.lastname: Fiorentino
authors.forename: G
authors.initials: G
authors.lastname: Casella
authors.forename: F
authors.initials: F
authors.lastname: Iodice
authors.forename: P
authors.initials: P
authors.lastname: Ricchi
authors.forename: C
authors.initials: C
authors.lastname: Carlomagno
authors.forename: E
authors.initials: E
authors.lastname: Varriale
authors.forename: G
authors.initials: G
authors.lastname: De Placido
authors.forename: S
authors.initials: S
authors.lastname: De Placido
authors.forename: A R
authors.initials: AR
authors.lastname: Bianco
authors.forename: S
authors.initials: S
authors.lastname: Pignata
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D019008:Drug Resistance, Neoplasm; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006402:Hematologic Diseases / Q000139:chemically induced / Q000517:prevention & control*; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage; D017671:Platinum Compounds / Q000627:therapeutic use; D011994:Recombinant Proteins; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D017671:Platinum Compounds; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D015251:Epirubicin; D017239:Paclitaxel; D000069585:Filgrastim