Literature DB >> 18410954

Topotecan weekly bolus chemotherapy for relapsed platinum-sensitive ovarian and peritoneal cancers.

Robert Morris1, Ronald D Alvarez, Stephen Andrews, John Malone, Christopher Bryant, Lance K Heilbrun, Daryn Smith, Veronica Schimp, Adnan Munkarah.   

Abstract

OBJECTIVE: Topotecan at a dose of 1.5 mg/m(2) on days 1 to 5 of a 21-day cycle is an approved therapy for recurrent ovarian cancer. However, heavily pretreated patients may be predisposed to hematologic adverse events. This prospective study, therefore, investigates the safety and efficacy of an alternate weekly schedule of topotecan in patients with recurrent ovarian or peritoneal cancer.
METHODS: Patients with potentially platinum-sensitive recurrent ovarian or peritoneal cancer were treated with 4.0 mg/m(2) weekly topotecan as tolerated until disease progression. Antitumor response and safety were assessed. Dose reductions, delays, or omissions were implemented for grades 3-4 adverse events.
RESULTS: Of the 41 enrolled patients (median age, 62 years; range, 42 to 82 years), 39 patients had ovarian cancer, and 2 patients had peritoneal cancer. The median platinum-free interval was 11.7 months. A median of 9 topotecan cycles (range, 1 to 45 doses) was administered. Weekly topotecan was well tolerated: 7 (17%) patients had grades 3-4 neutropenia, and 9 (22%) had grades 3-4 fatigue. No grade 4 thrombocytopenia or anemia was reported. Of 38 response-evaluable patients, 1 (3%) had a complete response, 8 (21%) had a partial response, 16 (42%) had stable disease, and 13 (34%) had progressive disease.
CONCLUSIONS: Weekly topotecan was well tolerated in patients with platinum-sensitive ovarian or peritoneal cancer at first relapse, with a hematologic profile that compared favorably with that of the 5-day topotecan regimen. Moreover, antitumor activity was similar to that reported for the 5-day regimen.

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Year:  2008        PMID: 18410954      PMCID: PMC3865862          DOI: 10.1016/j.ygyno.2008.02.028

Source DB:  PubMed          Journal:  Gynecol Oncol        ISSN: 0090-8258            Impact factor:   5.482


  21 in total

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Journal:  J Clin Oncol       Date:  1996-05       Impact factor: 44.544

4.  Efficacy and toxicity of weekly topotecan in recurrent epithelial ovarian and primary peritoneal cancer.

Authors:  Tamar Safra; Joseph Menczer; Rinat Bernstein; Shulem Shpigel; Moshe J Inbar; Dan Grisaru; Abraham Golan; Tally Levy
Journal:  Gynecol Oncol       Date:  2007-01-18       Impact factor: 5.482

5.  Topotecan, an active drug in the second-line treatment of epithelial ovarian cancer: results of a large European phase II study.

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6.  Randomized phase II study of two schedules of topotecan in previously treated patients with ovarian cancer: a National Cancer Institute of Canada Clinical Trials Group study.

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7.  Long-term survival in a phase III, randomised study of topotecan versus paclitaxel in advanced epithelial ovarian carcinoma.

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Review 8.  Management of treatment-related toxicity in advanced ovarian cancer.

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Review 9.  Alternate dosing schedules for topotecan in the treatment of recurrent ovarian cancer.

Authors:  Robert Morris; Adnan Munkarah
Journal:  Oncologist       Date:  2002

10.  Paclitaxel plus platinum-based chemotherapy versus conventional platinum-based chemotherapy in women with relapsed ovarian cancer: the ICON4/AGO-OVAR-2.2 trial.

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Review 4.  Chemotherapy for ovarian cancer in the older adult.

Authors:  Christopher B Steer
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5.  Trabectedin as single agent in relapsed advanced ovarian cancer: results from a retrospective pooled analysis of three phase II trials.

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