title: Heavily pretreated ovarian cancer patients treated by single-agent gemcitabine. A retrospective outcome comparison between platinum-sensitive and platinum-resistant patients.
abstract: To assess activity and toxicity of gemcitabine treatment in heavily pretreated epithelial ovarian cancer (EOC) patients and compare the outcome between platinum-sensitive and platinum-resistant patients. We conducted a retrospective analysis of 43 women with EOC treated with gemcitabine on Days 1, 8 and 15 every 28 days. Response was evaluated by physical examination and serial CA 125 measurements. The patients (median age 62 years, range 29-87) were previously exposed to a median of 3 (2-8) chemotherapy regimens. A median of 3.5 (1-14) gemcitabine cycles were administered. Eleven (25.6%) patients showed partial response, 19 (44.2%) had stable disease and 13 (30.2%) progressed. Among 22 platinum-sensitive and 21 platinum-resistant patients, the response rate was 45.5% and 4.7% respectively (p = 0.001), and the median time to progression was 5.0 and 2.8 months, respectively (p = 0.0006). The respective median survival was 16.5 and 6.3 months (p = 0.0001). Grade III-IV hematological toxicities included anemia in four (9.3%) patients, thrombocytopenia in four (9.3%) and leucopenia in two (4.7%). The main non-hematological toxicities were grade III fatigue in two patients (4.7%) and nausea and vomiting in two (4.7%). Single agent gemcitabine is an attractive option for heavily pretreated EOC patients. The significant difference between platinum-sensitive and resistant patients' warrants further investigation.
authors.affiliation: Department of Medical Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. safrat@bezeqint.net
authors.forename: Tamar
authors.initials: T
authors.lastname: Safra
authors.forename: Ilan
authors.initials: I
authors.lastname: Ron
authors.forename: Mona
authors.initials: M
authors.lastname: Boaz
authors.forename: Joseph
authors.initials: J
authors.lastname: Brenner
authors.forename: Dan
authors.initials: D
authors.lastname: Grisaru
authors.forename: Moshe
authors.initials: M
authors.lastname: Inbar
authors.forename: Henry
authors.initials: H
authors.lastname: Hayat
authors.forename: Joseph
authors.initials: J
authors.lastname: Menczer
authors.forename: Abraham
authors.initials: A
authors.lastname: Golan
authors.forename: Tally
authors.initials: T
authors.lastname: Levy
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy; D002288:Adenocarcinoma, Mucinous / Q000188:drug therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D018269:Carcinoma, Endometrioid / Q000188:drug therapy; D018284:Cystadenocarcinoma, Serous / Q000188:drug therapy; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D012264:Ribonucleotide Reductases / Q000037:antagonists & inhibitors; D016879:Salvage Therapy; D015996:Survival Rate; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D012264:Ribonucleotide Reductases; D000093542:Gemcitabine