BACKGROUND: The current treatment of patients with recurrent ovarian cancer who have received initial platinum- or taxane-based chemotherapy depends on the results of the initial chemotherapy. The purpose of this study was to evaluate how to make the selection of second-line agents for patients with recurrent ovarian carcinoma initially diagnosed as stage II to IV. METHODS: We conducted a retrospective crossover study in patients who received second-line chemotherapy at Jikei University School of Medicine. We evaluated the responses, progression-free survivals, survivals of second-line chemotherapy, and overall survivals after primary surgery for 51 patients. The treatment cohorts were defined as follows: TC1, patients who were given paclitaxel and carboplatin as first-line chemotherapy and who, upon recurrence, were treated with a platinum-based combination as second-line; and TC2, patients who were given a non-taxane-based platinum combination as first-line chemotherapy, followed, at the time of recurrence, with paclitaxel and carboplatin. RESULTS: The response rates of the second-line chemotherapy for the TC1 and TC2 groups were 44% and 25% (P=0.09). The median progression-free survivals of TC1 and TC2 were 12.9 and 6.4 months (P=0.018; hazard ratio [HR], 2.42; 95% confidence interval [CI], 1.16-5.04). The median survivals after second-line chemotherapy for the two groups were 16.8 and 10.4 months (P=0.007; HR, 2.78; 95% CI, 1.33-5.84) and overall survivals after primary surgery were 36.6 and 27.9 months (P=0.007; HR, 2.36; 95% CI, 1.07-5.21). CONCLUSION: The TC1 group demonstrated a significantly better response and extension of progression-free survival, as well as significantly better survival after crossover and overall survival after primary surgery. As this was a retrospective analysis, this effect should be considered as hypothesis-generating and assessed prospectively in other trials comparing these two chemotherapy schedules.
BACKGROUND: The current treatment of patients with recurrent ovarian cancer who have received initial platinum- or taxane-based chemotherapy depends on the results of the initial chemotherapy. The purpose of this study was to evaluate how to make the selection of second-line agents for patients with recurrent ovarian carcinoma initially diagnosed as stage II to IV. METHODS: We conducted a retrospective crossover study in patients who received second-line chemotherapy at Jikei University School of Medicine. We evaluated the responses, progression-free survivals, survivals of second-line chemotherapy, and overall survivals after primary surgery for 51 patients. The treatment cohorts were defined as follows: TC1, patients who were given paclitaxel and carboplatin as first-line chemotherapy and who, upon recurrence, were treated with a platinum-based combination as second-line; and TC2, patients who were given a non-taxane-based platinum combination as first-line chemotherapy, followed, at the time of recurrence, with paclitaxel and carboplatin. RESULTS: The response rates of the second-line chemotherapy for the TC1 and TC2 groups were 44% and 25% (P=0.09). The median progression-free survivals of TC1 and TC2 were 12.9 and 6.4 months (P=0.018; hazard ratio [HR], 2.42; 95% confidence interval [CI], 1.16-5.04). The median survivals after second-line chemotherapy for the two groups were 16.8 and 10.4 months (P=0.007; HR, 2.78; 95% CI, 1.33-5.84) and overall survivals after primary surgery were 36.6 and 27.9 months (P=0.007; HR, 2.36; 95% CI, 1.07-5.21). CONCLUSION: The TC1 group demonstrated a significantly better response and extension of progression-free survival, as well as significantly better survival after crossover and overall survival after primary surgery. As this was a retrospective analysis, this effect should be considered as hypothesis-generating and assessed prospectively in other trials comparing these two chemotherapy schedules.
Authors: F M Muggia; P S Braly; M F Brady; G Sutton; T H Niemann; S L Lentz; R D Alvarez; P R Kucera; J M Small Journal: J Clin Oncol Date: 2000-01 Impact factor: 44.544
Authors: P M Fracasso; M F Brady; D H Moore; J L Walker; P G Rose; L Letvak; T M Grogan; W P McGuire Journal: J Clin Oncol Date: 2001-06-15 Impact factor: 44.544
Authors: Maurie Markman; James Hall; Daniel Spitz; Sheldon Weiner; Linda Carson; Linda Van Le; Mark Baker Journal: J Clin Oncol Date: 2002-05-01 Impact factor: 44.544
Authors: M J Piccart; K Bertelsen; K James; J Cassidy; C Mangioni; E Simonsen; G Stuart; S Kaye; I Vergote; R Blom; R Grimshaw; R J Atkinson; K D Swenerton; C Trope; M Nardi; J Kaern; S Tumolo; P Timmers; J A Roy; F Lhoas; B Lindvall; M Bacon; A Birt; J E Andersen; B Zee; J Paul; B Baron; S Pecorelli Journal: J Natl Cancer Inst Date: 2000-05-03 Impact factor: 13.506
Authors: W P McGuire; W J Hoskins; M F Brady; P R Kucera; E E Partridge; K Y Look; D L Clarke-Pearson; M Davidson Journal: N Engl J Med Date: 1996-01-04 Impact factor: 91.245