title: Review role of topotecan in gynaecological cancers: current indications and perspectives.
abstract: BACKGROUND
  Ovarian cancer is the fourth cause of death from gynaecological cancer and cervical cancer is the first in women <45 years old in developing countries. The aim of this article is to review the role of topotecan (Hycamtin), a semi-synthetic alkaloid derivative of camptothecin, in ovarian and cervical cancer in monotherapy and in combination.
  
  
  METHODS
  This article reviews the mechanism of action, pharmacokinetics, toxicity and efficacy of topotecan. The paper also reports the principal phases II and III studies of topotecan in advanced or recurrent ovarian and cervical cancer.
  
  
  RESULTS
  Topotecan (Hycamtin), currently indicated for the treatment of relapsed ovarian cancer, has demonstrated activity both in platinum-sensitive and in platinum-resistant disease. The combination cisplatin-topotecan for the treatment of advanced and recurrent cervical cancer has demonstrated a clinical benefit in terms of response rate, overall survival and progression free survival. Haematological toxicity of topotecan also is easy to manage and not cumulative, especially with the weekly scheduled recently introduced in clinical practice.
  
  
  CONCLUSIONS
  Topotecan (Hycamtin) will continue to play a role in the treatment of advanced ovarian and cervical cancer, in monotherapy or in combination with other cytotoxic agents.
authors.affiliation: Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, IT-00168 Rome, Italy. kettalorusso@libero.it
authors.forename: Domenica
authors.initials: D
authors.lastname: Lorusso
authors.forename: Antonella
authors.initials: A
authors.lastname: Pietragalla
authors.forename: Sara
authors.initials: S
authors.lastname: Mainenti
authors.forename: Valeria
authors.initials: V
authors.lastname: Masciullo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Vagno
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004347:Drug Interactions; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy*; D006801:Humans; D019772:Topotecan / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D019772:Topotecan