title: Phase II trial of high-dose intravenous doxorubicin, etoposide, and cyclophosphamide with autologous stem cell support in patients with residual or responding recurrent ovarian cancer.
abstract: This study was performed in order to evaluate the toxicities, progression-free and overall survival of patients with responsive residual or recurrent ovarian cancer treated with high-dose chemotherapy. Twenty-seven patients were treated. Doxorubicin, 165 mg/m(2) over 96 h (days -12 to -8), etoposide 700 mg/m(2) every day x3 (days -6 to -4), and cyclophosphamide 4.2 g/m(2) on d -3 was followed by stem cells and granulocyte colony-stimulating factor. The median days of granulocyte count <500/microl was 14 (range 10-42) and platelets <20,000/microl was 13 (range 2-80). Median numbers of red cell and platelet transfusions were 15 (5-16) and 14 (4-103). Toxicity included mucositis requiring narcotic analgesia in all patients. Asymptomatic decreases in ejection fraction to values <50% were observed in four patients. No clinical congestive heart failure was observed. One death due to sepsis was observed. Median progression-free survival is 7.5 months (1.0-56 months); five patients remain alive, two of whom remain progression-free at 19.5 and 24.5 months post transplant. Median overall survival is 14.0 months (1-68 months). We conclude that high-dose anthracyclines may be safely administered to ovarian cancer patients. The short overall and progression-free survivals observed in our population suggest that this combination is not optimal.
authors.affiliation: Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA 91010, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Morgan
authors.forename: J H
authors.initials: JH
authors.lastname: Doroshow
authors.forename: L
authors.initials: L
authors.lastname: Leong
authors.forename: J
authors.initials: J
authors.lastname: Schriber
authors.forename: S
authors.initials: S
authors.lastname: Shibata
authors.forename: S
authors.initials: S
authors.lastname: Forman
authors.forename: V
authors.initials: V
authors.lastname: Hamasaki
authors.forename: K
authors.initials: K
authors.lastname: Margolin
authors.forename: G
authors.initials: G
authors.lastname: Somlo
authors.forename: J
authors.initials: J
authors.lastname: Alvarnas
authors.forename: M
authors.initials: M
authors.lastname: McNamara
authors.forename: J
authors.initials: J
authors.lastname: Longmate
authors.forename: J
authors.initials: J
authors.lastname: Raschko
authors.forename: W
authors.initials: W
authors.lastname: Chow
authors.forename: S
authors.initials: S
authors.lastname: Vasilev
authors.forename: K
authors.initials: K
authors.lastname: McGonigle
authors.forename: Y
authors.initials: Y
authors.lastname: Yen
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D018394:CA-125 Antigen / Q000032:analysis; D002277:Carcinoma / Q000097:blood / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery / Q000628:therapy; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis; D010051:Ovarian Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery / Q000628:therapy; D010052:Ovariectomy; D016019:Survival Analysis; D014182:Transplantation, Autologous; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D009363:Neoplasm Proteins; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide