Second-line chemotherapy for advanced or recurrent endometrial carcinoma previously treated with paclitaxel and carboplatin, with or without epirubicin.
OBJECTIVE
A combined chemotherapy of taxane and platinum, with or without anthracycline, has been used as a standard first-line regimen. The purpose of this study was to investigate the effectiveness of second-line chemotherapy for treatment of advanced or recurrent endometrial carcinoma previously treated with a combined chemotherapy of taxane and platinum, with or without anthracycline.


METHODS
During the 2000-2008 study period, 723 patients were diagnosed with endometrial cancer at the Departments of Obstetrics and Gynecology of the Osaka University and the Osaka Rosai Hospitals, Osaka, Japan. The subset of these cases that eventually required treatment by second-line chemotherapy was retrospectively analyzed.


RESULTS
Response rate to second-line chemotherapy was 25%. Treatment-free interval (TFI) of ≥ or <6 months was demonstrated to be significantly associated with the response to second-line chemotherapy (P = 0.0026), progression-free survival (P = 0.0003) and overall survival (P = 0.025). The second-line chemotherapy similar to the first-line regimen was ineffective in all the 7 cases (100%) whose TFI was shorter than 6 months. Multivariate analysis showed that TFI was the most significantly important factor predicting the effectiveness of second-line chemotherapy (the adjusted hazard ratio of TFI on PFS and OS: 3.482, 95% CI, 1.641-7.388, P = 0.0012, and 2.341, 95% CI, 1.034-5.301, P = 0.042, respectively).


CONCLUSIONS
Our present study provides, for the first time, evidence that the majority of refractory or recurrent diseases, if they occur within 6 months of a first-line chemotherapy using taxane and platinum with or without anthracycline, are non-responsive to the current regimens of second-line chemotherapy.
Ueda
Yutaka
Y
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan. ZVF03563@nifty.ne.jp
Miyake
Takahito
T
Egawa-Takata
Tomomi
T
Miyatake
Takashi
T
Matsuzaki
Shinya
S
Yokoyama
Takuhei
T
Yoshino
Kiyoshi
K
Fujita
Masami
M
Enomoto
Takayuki
T
Kimura
Tadashi
T
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000473:pathology; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D017239:Paclitaxel / Q000008:administration & dosage; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D015251:Epirubicin; D016190:Carboplatin; D017239:Paclitaxel