title: Oral cyclophosphamide in recurrent ovarian cancer.
abstract: OBJECTIVE
  Cyclophosphamide was widely used as a single agent prior to the advent of platinum-based regimens for epithelial ovarian cancer, and, in combination with platinum, prior to the adoption of platinum and paclitaxel as standard first-line therapy. As cyclophosphamide currently has no defined role in ovarian cancer we aimed to assess its activity in women with recurrent disease.
  
  
  METHODS
  A retrospective review was conducted of patients from three centers in Melbourne, Australia who had received oral cyclophosphamide treatment for recurrent ovarian cancer. The primary end-point was response rate to oral cyclophosphamide (150 mg p.o. day 1-14) based on Gynecologic Cancer InterGroup (GCIG) CA125 and/or Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Secondary end-points included overall and progression-free survival and toxicity.
  
  
  RESULTS
  In all, 26 patients were identified and 23 patients were evaluable for response. The median number of prior chemotherapy regimens was three (range 1-6). The response rate to oral cyclophosphamide was 44% with 10 of the 23 patients achieving a partial response (PR) based on GCIG (CA125) criteria. The median number of cycles received was three (range 1-16). Cyclophosphamide showed activity both in patients with platinum-sensitive (seven of 13 PR) and resistant or refractory disease (three of 10 PR). There was no grade 3 or 4 toxicity but two patients ceased cyclophosphamide due to less severe non-hematological toxicity.
  
  
  CONCLUSIONS
  Single agent oral cyclophosphamide is active and well tolerated in recurrent ovarian cancer. Further investigation of oral cyclophosphamide in patients with platinum-sensitive and platinum-resistant disease is warranted.
authors.affiliation: Royal Women's Hospital, Melbourne, Victoria, Australia.|Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
authors.forename: Despina
authors.initials: D
authors.lastname: Handolias
authors.affiliation: Royal Women's Hospital, Melbourne, Victoria, Australia.|University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Quinn
authors.affiliation: Mercy Hospital for Women, Melbourne, Victoria, Australia.
authors.forename: Serene
authors.initials: S
authors.lastname: Foo
authors.affiliation: Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.|University of Melbourne, Melbourne, Victoria, Australia.|Mercy Hospital for Women, Melbourne, Victoria, Australia.
authors.forename: Linda
authors.initials: L
authors.lastname: Mileshkin
authors.affiliation: University of Melbourne, Melbourne, Victoria, Australia.|Mercy Hospital for Women, Melbourne, Victoria, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Grant
authors.affiliation: Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
authors.forename: Gaelle
authors.initials: G
authors.lastname: Dutu
authors.affiliation: Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.|University of Melbourne, Melbourne, Victoria, Australia.|Mercy Hospital for Women, Melbourne, Victoria, Australia.
authors.forename: Danny
authors.initials: D
authors.lastname: Rischin
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage* / Q000009:adverse effects; D001315:Australia; D000077216:Carcinoma, Ovarian Epithelial; D003520:Cyclophosphamide / Q000008:administration & dosage* / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy* / Q000401:mortality; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003520:Cyclophosphamide
keywords: cancer; cyclophosphamide; ovarian; platinum; recurrence