title: Topotecan weekly bolus chemotherapy for relapsed platinum-sensitive ovarian and peritoneal cancers.
abstract: OBJECTIVE
  Topotecan at a dose of 1.5 mg/m(2) on days 1 to 5 of a 21-day cycle is an approved therapy for recurrent ovarian cancer. However, heavily pretreated patients may be predisposed to hematologic adverse events. This prospective study, therefore, investigates the safety and efficacy of an alternate weekly schedule of topotecan in patients with recurrent ovarian or peritoneal cancer.
  
  
  METHODS
  Patients with potentially platinum-sensitive recurrent ovarian or peritoneal cancer were treated with 4.0 mg/m(2) weekly topotecan as tolerated until disease progression. Antitumor response and safety were assessed. Dose reductions, delays, or omissions were implemented for grades 3-4 adverse events.
  
  
  RESULTS
  Of the 41 enrolled patients (median age, 62 years; range, 42 to 82 years), 39 patients had ovarian cancer, and 2 patients had peritoneal cancer. The median platinum-free interval was 11.7 months. A median of 9 topotecan cycles (range, 1 to 45 doses) was administered. Weekly topotecan was well tolerated: 7 (17%) patients had grades 3-4 neutropenia, and 9 (22%) had grades 3-4 fatigue. No grade 4 thrombocytopenia or anemia was reported. Of 38 response-evaluable patients, 1 (3%) had a complete response, 8 (21%) had a partial response, 16 (42%) had stable disease, and 13 (34%) had progressive disease.
  
  
  CONCLUSIONS
  Weekly topotecan was well tolerated in patients with platinum-sensitive ovarian or peritoneal cancer at first relapse, with a hematologic profile that compared favorably with that of the 5-day topotecan regimen. Moreover, antitumor activity was similar to that reported for the 5-day regimen.
authors.affiliation: Wayne State University School of Medicine, Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, USA. rmorris@med.wayne.edu
authors.forename: Robert
authors.initials: R
authors.lastname: Morris
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Alvarez
authors.forename: Stephen
authors.initials: S
authors.lastname: Andrews
authors.forename: John
authors.initials: J
authors.lastname: Malone
authors.forename: Christopher
authors.initials: C
authors.lastname: Bryant
authors.forename: Lance K
authors.initials: LK
authors.lastname: Heilbrun
authors.forename: Daryn
authors.initials: D
authors.lastname: Smith
authors.forename: Veronica
authors.initials: V
authors.lastname: Schimp
authors.forename: Adnan
authors.initials: A
authors.lastname: Munkarah
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011446:Prospective Studies; D015996:Survival Rate; D019772:Topotecan / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000970:Antineoplastic Agents; D019772:Topotecan