title: Paclitaxel-ifosfamide-carboplatin combination chemotherapy regimen in advanced uterine and adnexal malignant mixed Mullerian tumours.
abstract: BACKGROUND
  Malignant mixed Mullerian tumours (MMMTs) of the uterus and adnexa represent aggressive gynaecologic malignancies with a high rate of loco-regional and distant failure. For that reason, we evaluated the paclitaxel-ifosfamide-carboplatin (TICb) combination in patients with advanced MMMTs.
  
  
  METHODS
  Female patients with advanced MMMTs, WHO-PS 0-2, no prior chemotherapy for systemic disease, unimpaired haemopoietic and organ function were eligible. Chemotherapy was administered at the following doses; paclitaxel: 175 mg m(-2) on day 1, ifosfamide: 2.0 g m(-2) day(-1)--days 1 and 2, and carboplatin at a target area under the curve 5 on day 2, with prophylactic G-CSF from day 3.
  
  
  RESULTS
  Forty patients of a median age 61 (45-72) years, performance status 0-2 with advanced MMMTs of the uterus (n=34), tubes (n=2) or ovary (n=4) have entered and all were evaluable for response and toxicity. Responses were as follows: 27 out of 40 (67.5%) evaluable patients responded, with 11 complete responses and 16 partial responses, while 10 had stable disease, and 3 developed progressive disease. The median response duration was 9 months (range, 4-40 months), median progression-free survival 13 months (range, 3-42 months), while median overall survival 18 months (range, 4-48 months). Grade 3/4 neutropenia was recorded in 22 out of 40 (55%)--with 13 developing grade 4 (≤7 days) and 7 out of 40 (17.5%) of patients at least one episode of febrile neutropenia.
  
  
  CONCLUSIONS
  In this study, it appears that the TICb combination, yielded important activity with manageable toxicity in females with advanced MMMTs warranting further randomised comparison with current standard regimens.
authors.affiliation: Second Division of Medical Oncology, Department of Medicine, Metaxa Cancer Hospital, Piraeus, Greece. ckosm1@ath.forthnet.gr
authors.forename: C
authors.initials: C
authors.lastname: Kosmas
authors.forename: G
authors.initials: G
authors.lastname: Vorgias
authors.forename: G
authors.initials: G
authors.lastname: Tsakonas
authors.forename: P
authors.initials: P
authors.lastname: Politis
authors.forename: T
authors.initials: T
authors.lastname: Daladimos
authors.forename: E
authors.initials: E
authors.lastname: Panagiotidi
authors.forename: T
authors.initials: T
authors.lastname: Papachrysanthou
authors.forename: D
authors.initials: D
authors.lastname: Moschovis
authors.forename: N
authors.initials: N
authors.lastname: Kalinoglou
authors.forename: N
authors.initials: N
authors.lastname: Tsavaris
authors.forename: A
authors.initials: A
authors.lastname: Karabelis
authors.forename: N
authors.initials: N
authors.lastname: Mylonakis
mesh_terms: D000291:Adnexal Diseases / Q000188:drug therapy* / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D018198:Mixed Tumor, Malignant / Q000188:drug therapy* / Q000556:secondary; D018200:Mixed Tumor, Mullerian / Q000188:drug therapy* / Q000556:secondary; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000556:secondary; D055815:Young Adult
chemical_list: D016190:Carboplatin; D017239:Paclitaxel; D007069:Ifosfamide