title: Topotecan and liposomal doxorubicin in recurrent ovarian cancer: is sequence important?
abstract: A variety of agents have emerged to treat patients with recurrent epithelial ovarian cancer (EOC). Most patients receive both topotecan (T) and liposomal doxorubicin (D); however, there are no data regarding the benefit of a sequence-D followed by T (DT) or T followed by D (TD). We identified 89 consecutive patients with recurrent EOC, who received both D and T from January 1994 to January 2004 at Memorial Hospital. We compared the duration of treatment, toxicity, and overall survival (OS) for patients who received either DT or TD. Sixty-four patients received DT, and 25 patients received TD. The groups were balanced regarding age, stage, surgical debulking, platinum sensitivity, prior therapy, and intervening drugs between D and T. Median numbers of cycles on DT and TD were seven and six, respectively (P= 0.61); there was no difference in duration based on platinum sensitivity. Removal from therapy for toxicity was similar, DT (22%) and TD (36%) (P= 0.18). Finally, there was no difference in median OS based on sequence, DT (18.28 months) and TD (17.75 months) (P= NS). Platinum sensitivity did not affect median OS based on sequence. Based on duration, toxicity, and OS there is no advantage of one sequence of D and T when treating patients with recurrent EOC.
authors.affiliation: Developmental Chemotherapy Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. dupontj@mskcc.org
authors.forename: J
authors.initials: J
authors.lastname: Dupont
authors.forename: C
authors.initials: C
authors.lastname: Aghajanian
authors.forename: G
authors.initials: G
authors.lastname: Andrea
authors.forename: M
authors.initials: M
authors.lastname: Lovegren
authors.forename: S
authors.initials: S
authors.lastname: Chuai
authors.forename: E
authors.initials: E
authors.lastname: Venkatraman
authors.forename: M
authors.initials: M
authors.lastname: Hensley
authors.forename: S
authors.initials: S
authors.lastname: Anderson
authors.forename: D
authors.initials: D
authors.lastname: Spriggs
authors.forename: P
authors.initials: P
authors.lastname: Sabbatini
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D017671:Platinum Compounds / Q000627:therapeutic use; D012189:Retrospective Studies; D016019:Survival Analysis; D019772:Topotecan / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D017671:Platinum Compounds; D019772:Topotecan; D004317:Doxorubicin