Comparison of the efficacy between topotecan- and belotecan-, a new camptothecin analog, based chemotherapies for recurrent epithelial ovarian cancer: a single institutional experience.
OBJECTIVE
To compare the efficacy and toxicity between topotecan- and belotecan-based chemotherapies in recurrent epithelial ovarian cancer (EOC).


METHODS
The clinical data of 80 patients treated with topotecan- (n = 45) or belotecan- (n = 35) based chemotherapy as at least a second-line chemotherapy were reviewed retrospectively between July 2001 and December 2007. Response was evaluated using the Response Evaluation Criteria in Solid Tumours (RECIST) and serum CA-125 levels. Hematological toxicity was examined according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 2.0. Time to progressive disease (TTPD), chemotherapy-specific survival (CSS) and overall survival (OS) according to the 2 chemotherapies were evaluated by the Kaplan-Meier analysis with the log-rank test.


RESULTS
Overall response rate (ORR) was 24.4% in patients treated with topotecan-based chemotherapy, while it was 45.7% in those treated with belotecan-based chemotherapy (P = 0.046). Moreover, ORR was higher in platinum-sensitive patients treated with belotecan-based chemotherapy (58.8%) than those treated with topotecan-based chemotherapy (22.2%) (P = 0.041) although it was not significantly different in platinum-resistant patients (P = 0.471). Grade 3 or 4 anemia, neutropenia and thrombocytopenia developed in 14.8% vs 3.6%, 43.1% vs 55.6%, and 20.0% vs 12.8% of cycles in topotecan- and belotecan-based chemotherapies, respectively (P < 0.05). There were no significant difference in survival between the 2 chemotherapies.


CONCLUSIONS
In our experience, belotecan-based chemotherapy seemed to be efficient with acceptable toxicity, compared to topotecan-based chemotherapy in recurrent EOC. However, randomized controlled trials are required for the comparison of the efficacy and toxicity between topotecan- and belotecan-based chemotherapies in recurrent EOC.
Kim
Hee Seung
HS
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Park
Noh Hyun
NH
Kang
Sokbom
S
Seo
Sang-Soo
SS
Chung
Hyun Hoon
HH
Kim
Jae Weon
JW
Song
Yong Sang
YS
Kang
Soon-Beom
SB
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D004848:Epithelium; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D016019:Survival Analysis; D019772:Topotecan / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D000970:Antineoplastic Agents; C116963:belotecan; D019772:Topotecan; D002945:Cisplatin; D002166:Camptothecin