title: Response to and toxicity of gemcitabine for recurrent ovarian cancer according to number of previous chemotherapy regimens.
abstract: OBJECTIVE
  Gemcitabine is used not only as a second-line, but also as a third-line or higher regimen for taxane/platinum-resistant recurrent ovarian cancer. The purpose of this study was to clarify the response to and toxicity of gemcitabine for recurrent ovarian cancer according to the number of previous chemotherapy regimens.
  
  
  METHODS
  The subjects were patients with taxane/platinum-resistant recurrent ovarian cancer on gemcitabine treatment at the present hospital between June 2007 and September 2013. We retrospectively reviewed the medical records. Response and adverse events were assessed using the Response Evaluation Criteria in Solid Tumors version 1.1. and the Common Terminology Criteria for Adverse Events v4.0, respectively.
  
  
  RESULTS
  The subjects consisted of 65 patients. The median number of previous chemotherapy regimens was 3 (range, 1-7). Overall response rate was 4.6%, and disease control rate (DCR) was 40.0%. DCR versus one, two, three, and ≥four previous chemotherapy regimens was 83.3%, 45.0%, 36.4%, and 23.5%, respectively. Grade 3/4 neutropenia, anemia, and thrombocytopenia occurred in 52.3%, 9.2%, and 9.2% of patients, respectively. Prevalence of grade 3/4 neutropenia according to one, two, three, and ≥four previous chemotherapy regimens was 66.7%, 55.0%, 54.5%, and 41.2%, respectively. Prevalence of anemia, thrombocytopenia, and almost all the non-hematological toxicities also did not increase with an increase in the number of previous chemotherapy regimens.
  
  
  CONCLUSIONS
  Although DCR decreased as the number of previous chemotherapy regimens increased, the toxicities did not increase. Gemcitabine may be relatively safe in heavily pretreated ovarian cancer patients.
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Takei
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan.
authors.forename: Shizuo
authors.initials: S
authors.lastname: Machida
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan.
authors.forename: Akiyo
authors.initials: A
authors.lastname: Taneichi
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan.
authors.forename: Suzuyo
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Nagashima
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Morisawa
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Saga
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Matsubara
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujiwara
mesh_terms: D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000494:pharmacology* / Q000633:toxicity; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000633:toxicity; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D017063:Outcome Assessment, Health Care; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine
keywords: gemcitabine; ovarian cancer; previous chemotherapy regimen; response; toxicity