Filgrastim support during combination chemotherapy using cisplatin, doxorubicin, and cyclophosphamide to treat advanced or recurrent endometrial cancer: a clinical study and literature review.

In a private practice setting, 16 patients with advanced or recurrent endometrial carcinoma received cisplatinum 50 mg/m2, doxorubicin 50 mg/m2, and cyclophosphamide 750 mg/m2 every three weeks. Growth factor support using filgrastim was initiated on the first cycle of therapy and each subsequent cycle. Sixteen patients were entered into the study with 13 being evaluable. No patient had previously received chemotherapy. The overall response rate was 54% with two complete responses (15%) and five partial responses (38%). Stable disease was seen in 46% of patients. Progression-free survival was observed to be a median of 8.5 months for a complete response, a median of 8.5 months for a partial response and a median of 7 months for stable disease. Fifteen percent of the patients and 3% of all chemotherapy cycles had febrile neutropenic events. There were no deaths due to myelotoxicity. Only one patient required a dose reduction due to neutropenia. Four of the 13 patients required dose reductions due to previous nadir thrombocytopenia. Grade 4 granulocytopenia occurred in 28% of treatment cycles and grade 3 granulocytopenia occurred in 12% of treatment cycles. The use of filgrastim (G-CSF) allowed patients to stay on therapy for an average of seven treatments. Neutropenia was not the dose-limiting toxicity from this dose-intense regimen.