Weekly carboplatin and paclitaxel is safe, active, and well tolerated in recurrent ovarian cancer cases of Japanese women previously treated with cisplatin-containing multidrug chemotherapy.
The safety and efficacy of weekly carboplatin and paclitaxel administration in recurrent ovarian cancers after platinum-containing multidrug chemotherapy were tested. Japanese patients who achieved complete response with surgery and adjuvant platinum-based chemotherapy and who had a recurrence after at least 6 months were included in the case - control study. Twenty-seven cases received the weekly TJ (WTJ) regime (cohort 1: T = 80 mg/m(2), J = AUC 2, median course = 13, range = 3-26) and 41 received other regimens [cohort 2: CAP = 37, monthly TJ (MTJ) = 4]. Toxicity profile, response rate, therapeutic index (TI), and survival were analyzed. Neutropenia, thrombocytopenia, and peripheral neuropathy (grades 3 and 4) in cohorts 1 and 2 were 1.7% and 90%, 5.1% and 14.3%, and 0% and 4.8%, respectively. Response rates were 77.8% and . Thus, TI of the two cohorts was 3.9 and 1.9, respectively. The median survival of cohort 1 was 48.3 months (95% CI 11.5-85.0) whereas that of cohort 2 was 17.8 months (95% CI 5.3-30.3, P < 0.005). WTJ has better toxicity profile and TI than monthly platinum-based multidrug regimens for recurrent ovarian cancers in Japanese women. As second-line treatment of ovarian cancer should primarily provide high TI, WTJ regimen appears a better candidate, but its long-term survival benefit should be tested against MTJ.
Kikuchi
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A
Department of Obstetrics and Gynecology, Nihon University School of Medicine, 30-1 Oyaguchi, Kamimachi, Itabashi, Tokyo 173-8610, Japan.
Sakamoto
H
H
Yamamoto
T
T
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016190:Carboplatin / Q000008:administration & dosage; D016022:Case-Control Studies; D002945:Cisplatin / Q000627:therapeutic use; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007564:Japan; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017239:Paclitaxel / Q000008:administration & dosage; D016019:Survival Analysis; D016896:Treatment Outcome
D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin