Role of salvage chemotherapy with topotecan and cisplatin in patients with paclitaxel- and platinum-resistant recurrent ovarian or primary peritoneal cancer: A phase II pilot study

Sharad A Ghamande, M. Steven Piver

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background and Objectives: We assessed the role of salvage chemotherapy with topotecan and cisplatin in patients with platinum- and paclitaxel- resistant advanced and recurrent ovarian or primary peritoneal cancer, based on the reported in vivo and in vitro synergism between these two drugs. Methods: Twenty patients were entered in this phase II trial from November 1997 to November 1998. They received cisplatin at 50 mg/m2 on day 1 with topotecan at 0.6 mg/m2 from day 1 to 5 every 28 days. In 70% of patients (14/20), this combination represented at least a third line of therapy. Results: A clinical response rate of 13.3% (two partial responses) was obtained in the 15 patients with evaluable disease. Sixty percent of patients (9/15) had stable disease and 26.7% (4/15) had progression. The median progression-free interval and survival were 4 months and 7 months, respectively. The 20 patients evaluable for toxicity received a mean of four chemotherapy cycles. Dose reductions were required in 45% of patients despite the administration of growth factors. The major dose-limiting toxicity was 50% occurrence (10/20) of grade 4 thrombocytopenia and 30% (6/20) grade 4 neutropenia. There was one septic death. Conclusions: These data suggest that combination therapy with topotecan and cisplatin has minimal activity in platinum- and paclitaxel-resistant advanced and recurrent ovarian or primary peritoneal cancer at the doses utilized in this trial.

Original languageEnglish (US)
Pages (from-to)162-166
Number of pages5
JournalJournal of Surgical Oncology
Volume72
Issue number3
DOIs
StatePublished - Dec 6 1999
Externally publishedYes

Fingerprint

Topotecan
Paclitaxel
Platinum
Cisplatin
Drug Therapy
Neoplasms
Neutropenia
Disease-Free Survival
Intercellular Signaling Peptides and Proteins
Therapeutics
Pharmaceutical Preparations

Keywords

  • Cisplatin
  • Ovarian cancer
  • Paclitaxel
  • Primary peritoneal cancer
  • Recurrence
  • Topotecan

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

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title = "Role of salvage chemotherapy with topotecan and cisplatin in patients with paclitaxel- and platinum-resistant recurrent ovarian or primary peritoneal cancer: A phase II pilot study",
abstract = "Background and Objectives: We assessed the role of salvage chemotherapy with topotecan and cisplatin in patients with platinum- and paclitaxel- resistant advanced and recurrent ovarian or primary peritoneal cancer, based on the reported in vivo and in vitro synergism between these two drugs. Methods: Twenty patients were entered in this phase II trial from November 1997 to November 1998. They received cisplatin at 50 mg/m2 on day 1 with topotecan at 0.6 mg/m2 from day 1 to 5 every 28 days. In 70{\%} of patients (14/20), this combination represented at least a third line of therapy. Results: A clinical response rate of 13.3{\%} (two partial responses) was obtained in the 15 patients with evaluable disease. Sixty percent of patients (9/15) had stable disease and 26.7{\%} (4/15) had progression. The median progression-free interval and survival were 4 months and 7 months, respectively. The 20 patients evaluable for toxicity received a mean of four chemotherapy cycles. Dose reductions were required in 45{\%} of patients despite the administration of growth factors. The major dose-limiting toxicity was 50{\%} occurrence (10/20) of grade 4 thrombocytopenia and 30{\%} (6/20) grade 4 neutropenia. There was one septic death. Conclusions: These data suggest that combination therapy with topotecan and cisplatin has minimal activity in platinum- and paclitaxel-resistant advanced and recurrent ovarian or primary peritoneal cancer at the doses utilized in this trial.",
keywords = "Cisplatin, Ovarian cancer, Paclitaxel, Primary peritoneal cancer, Recurrence, Topotecan",
author = "Ghamande, {Sharad A} and Piver, {M. Steven}",
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T1 - Role of salvage chemotherapy with topotecan and cisplatin in patients with paclitaxel- and platinum-resistant recurrent ovarian or primary peritoneal cancer

T2 - A phase II pilot study

AU - Ghamande, Sharad A

AU - Piver, M. Steven

PY - 1999/12/6

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AB - Background and Objectives: We assessed the role of salvage chemotherapy with topotecan and cisplatin in patients with platinum- and paclitaxel- resistant advanced and recurrent ovarian or primary peritoneal cancer, based on the reported in vivo and in vitro synergism between these two drugs. Methods: Twenty patients were entered in this phase II trial from November 1997 to November 1998. They received cisplatin at 50 mg/m2 on day 1 with topotecan at 0.6 mg/m2 from day 1 to 5 every 28 days. In 70% of patients (14/20), this combination represented at least a third line of therapy. Results: A clinical response rate of 13.3% (two partial responses) was obtained in the 15 patients with evaluable disease. Sixty percent of patients (9/15) had stable disease and 26.7% (4/15) had progression. The median progression-free interval and survival were 4 months and 7 months, respectively. The 20 patients evaluable for toxicity received a mean of four chemotherapy cycles. Dose reductions were required in 45% of patients despite the administration of growth factors. The major dose-limiting toxicity was 50% occurrence (10/20) of grade 4 thrombocytopenia and 30% (6/20) grade 4 neutropenia. There was one septic death. Conclusions: These data suggest that combination therapy with topotecan and cisplatin has minimal activity in platinum- and paclitaxel-resistant advanced and recurrent ovarian or primary peritoneal cancer at the doses utilized in this trial.

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KW - Ovarian cancer

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