Topotecan as a continuous infusion over 14 days in recurrent ovarian cancer patients.
OBJECTIVE
In recurrent ovarian cancer the topoisomerase-1 inhibitor topotecan shows activity after prior treatment with platinum and taxanes. Overall response rates of up to 38% in combination with an acceptable toxicity profile have been reported. We performed a pilot study to evaluate the therapeutic efficacy and toxicity profile of a low-dose continuous infusion protocol of topotecan.


METHODS
Twelve patients with recurrent ovarian cancer and a measurable lesion received a continuous infusion of topotecan (0.4 mg/m2/d) over 14 days, repeated every 28 days. All patients had at least one prior platinum-containing regimen of chemotherapy (range 1-7). Responses were evaluated by ultrasound, computed tomography (CT) scans and/or magnetic resonance imaging (MRI).


RESULTS
A total of 57 (median 5, range 1-12) topotecan treatment cycles were administered. The overall response rate was 2/12 (17%). Four patients had stable disease (33%), among them two patients with platinum-refractory tumors. The median time to progression was 26 (range 20-100) weeks. No grade 3 or 4 hematological toxicities were observed. However, one patient developed a grade 2 allergy leading to discontinuation of topotecan.


CONCLUSIONS
Treatment of recurrent ovarian cancer with low-dose continuous infusion of topotecan over 14 days demonstrated response rates comparable to other dosing schedules with minimal toxicity in a preliminary series of 12 patients.
Denschlag
D
D
Department of Gynecology and Obstetrics, University of Freiburg School of Medicine, Freiburg, Germany. ddenschl@frk.ukl.uni-freiburg.de
Watermann
D
D
Hörig
K
K
Kissel
C
C
Tempfer
C
C
Gitsch
G
G
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D018283:Cystadenocarcinoma, Papillary / Q000188:drug therapy*; D018284:Cystadenocarcinoma, Serous / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D010865:Pilot Projects; D019772:Topotecan / Q000008:administration & dosage* / Q000009:adverse effects
D000970:Antineoplastic Agents; D019772:Topotecan