title: Clinical consequences of the Calypso trial showing superiority of PEG-liposomal doxorubicin and carboplatin over paclitaxel and carboplatin in recurrent ovarian cancer: results of an Austrian gynecologic oncologists' expert meeting.
abstract: The Calypso trial showed an improved progression-free survival with PEG-liposomal doxorubicin (PLD) and carboplatin (P) as compared with the standard regimen paclitaxel (PCLTX) and P in the second- or third-line treatment of platinum-sensitive epithelial ovarian cancer [1]. A panel of Austrian gynecologic oncologists discussed the clinical consequences of the data from the Calypso study for the routine practice. PLD + P had a significantly lower rate of alopecia and neuropathy than the taxane regimen, both toxicities which compromise the quality of life. Due to possible significant thrombocytopenia, the blood counts of patients undergoing PLD + P therapy should be monitored weekly. Patients receiving PLD/P are at higher risk of nausea and vomiting. Palmoplantar erythrodysesthesia (hand-foot syndrome) is a significant toxicity of PLD + P most prevalent after the third or fourth cycle. Prophylaxis consists of avoiding pressure on feet and hands and other parts of the body. Similarly, prophylaxis of mucositis seems important and includes avoiding consumption of hot, spicy and salty foods and drinks. Mouth dryness should be avoided. Premedication with antiemetics and dexamethasone dissolved in 5% glucose is done to prevent hypersensitivity to PLD. In conclusion, the therapeutic index is more favorable for PLD + P than for PCTX + P.
authors.affiliation: Department of Gynecology and Obstetrics, Medical University of Graz, Graz, Austria. edgar.petru@medunigraz.at
authors.forename: Edgar
authors.initials: E
authors.lastname: Petru
authors.forename: Alexander
authors.initials: A
authors.lastname: Reinthaller
authors.forename: Lukas
authors.initials: L
authors.lastname: Angleitner-Boubenizek
authors.forename: Christian
authors.initials: C
authors.lastname: Schauer
authors.forename: Alain
authors.initials: A
authors.lastname: Zeimet
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Dirschlmayer
authors.forename: Michael
authors.initials: M
authors.lastname: Medl
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Stummvoll
authors.forename: Paul
authors.initials: P
authors.lastname: Sevelda
authors.forename: Christian
authors.initials: C
authors.lastname: Marth
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001317:Austria / Q000453:epidemiology; D016190:Carboplatin / Q000627:therapeutic use; D004317:Doxorubicin / Q000031:analogs & derivatives / Q000627:therapeutic use; D005104:Expert Testimony; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality*; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D017239:Paclitaxel / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000627:therapeutic use; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D004317:Doxorubicin; D016190:Carboplatin; D017239:Paclitaxel