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DOI: 10.4103/2278-330X.181629
Tolerance of weekly metronomic paclitaxel and carboplatin as neoadjuvant chemotherapy in advanced ovarian cancer patients who are unlikely to tolerate 3 weekly paclitaxel and carboplatin
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Abstract
Objective: There are little data regarding safety and effectiveness of neoadjuvant chemotherapy (NACT) in patients who are considered unfit for receiving 3 weekly paclitaxel and carboplatin. The aim of this study was to examine the toxicity and response rates of weekly paclitaxel and carboplatin as NACT in such cohort of patients. Methods: Study population included advanced ovarian cancer patients who were unlikely to tolerate 3 weekly paclitaxel and carboplatin and hence received weekly paclitaxel (80 mg/m 2) and carboplatin AUC-2 as NACT. The data regarding the baseline characteristics, chemotherapy tolerance, completion rates, toxicity (Common Terminology Criteria for Adverse Events version 4.02), and radiological response rates are presented. SPSS version 16 was used for analysis. Descriptive statistics is presented. Results: Eleven patients received this schedule. Nine patients completed nine cycles of NACT. Except one, all patients completed NACT with an average relative dose intensity of >0.8. There was no chemotherapy-related mortality. Grade 3-4 life-threatening complications were seen in two patients. The post NACT response rate was 100%. Conclusions: Weekly paclitaxel and carboplatin chemotherapy is safe and efficacious in patients who are unsuitable for 3 weekly paclitaxel and carboplatin chemotherapy schedules.
Key words
Intolerable - metronomic - neoadjuvant chemotherapy - poor nutritional status - poor performance statusPublikationsverlauf
Artikel online veröffentlicht:
28. Dezember 2020
© 2016. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)
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References
- 1 Vergote I, Tropé CG, Amant F, Kristensen GB, Ehlen T, Johnson N, et al. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med 2010;363:943-53.
- 2 Kehoe S, Hook J, Nankivell M, Jayson GC, Kitchener HC, Lopes T, et al. Chemotherapy or upfront surgery for newly diagnosed advanced ovarian cancer: Results from the MRC CHORUS trial. J Clin Oncol 2013;31Suppl; Abstr 5500. Available from: http://www.meetinglibrary.asco.org/content/112631-132. [Last cited on 2014 Jul 07].
- 3 Jordan S, Steer C, DeFazio A, Quinn M, Obermair A, Friedlander M, et al. Patterns of chemotherapy treatment for women with invasive epithelial ovarian cancer - A population-based study. Gynecol Oncol 2013;129:310-7.
- 4 Piura B, Meirovitz M. Weekly carboplatin in a frail elderly woman with advanced peritoneal carcinoma. Arch Gynecol Obstet 2005;273:192-4.
- 5 Fauci JM, Whitworth JM, Schneider KE, Subramaniam A, Zhang B, Frederick PJ, et al. Prognostic significance of the relative dose intensity of chemotherapy in primary treatment of epithelial ovarian cancer. Gynecol Oncol 2011;122:532-5.
- 6 Hanna RK, Poniewierski MS, Laskey RA, Lopez MA, Shafer A, Van Le L, et al. Predictors of reduced relative dose intensity and its relationship to mortality in women receiving multi-agent chemotherapy for epithelial ovarian cancer. Gynecol Oncol 2013;129:74-80.
- 7 Katsumata N, Yasuda M, Isonishi S, Takahashi F, Michimae H, Kimura E, et al. Long-term results of dose-dense paclitaxel and carboplatin versus conventional paclitaxel and carboplatin for treatment of advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer (JGOG 3016): A randomised, controlled, open-label trial. Lancet Oncol 2013;14:1020-6.
- 8 Safra T, Menczer J, Bernstein RM, Shpigel S, Matcejevsky D, Inbar MJ, et al. Combined weekly carboplatin and paclitaxel as primary treatment of advanced epithelial ovarian carcinoma. Gynecol Oncol 2009;114:215-8.
- 9 Uyar D, Frasure HE, Markman M, von Gruenigen VE. Treatment patterns by decade of life in elderly women (> or =70 years of age) with ovarian cancer. Gynecol Oncol 2005;98:403-8.
- 10 Wright J, Doan T, McBride R, Jacobson J, Hershman D. Variability in chemotherapy delivery for elderly women with advanced stage ovarian cancer and its impact on survival. Br J Cancer 2008;98:1197-203.
- 11 Trillsch F, Woelber L, Eulenburg C, Braicu I, Lambrechts S, Chekerov R, et al. Treatment reality in elderly patients with advanced ovarian cancer: A prospective analysis of the OVCAD consortium. J Ovarian Res 2013;6:42.
- 12 Matulonis UA, Krag KJ, Krasner CN, Atkinson T, Horowitz NS, Lee H, et al. Phase II prospective study of paclitaxel and carboplatin in older patients with newly diagnosed müllerian tumors. Gynecol Oncol 2009;112:394-9.
- 13 Freyer G, Tew WP, Moore KN. Treatment and trials: Ovarian cancer in older women. Am Soc Clin Oncol Educ Book 2013;227-35.
- 14 Geisler JP, Linnemeier GC, Thomas AJ, Manahan KJ. Nutritional assessment using prealbumin as an objective criterion to determine whom should not undergo primary radical cytoreductive surgery for ovarian cancer. Gynecol Oncol 2007;106:128-31.
- 15 Palaia I, Loprete E, Musella A, Marchetti C, Di Donato V, Bellati F, et al. Chemotherapy in elderly patients with gynecological cancer. Oncology 2013;85:168-72.
- 16 Pignata S, Scambia G, Katsaros D, Gallo C, Pujade-Lauraine E, De Placido S, et al. Carboplatin plus paclitaxel once a week versus every 3 weeks in patients with advanced ovarian cancer (MITO-7): A randomised, multicentre, open-label, phase 3 trial. Lancet Oncol 2014;15:396-405.
- 17 Pignata S, Breda E, Scambia G, Pisano C, Zagonel V, Lorusso D, et al. A phase II study of weekly carboplatin and paclitaxel as first-line treatment of elderly patients with advanced ovarian cancer. A Multicentre Italian Trial in Ovarian cancer (MITO-5) study. Crit Rev Oncol Hematol 2008;66:229-36.
- 18 Gonzalez-Martin A, Gladieff L, Tholander B, Stroyakovsky D, Gore M, Scambia G, et al. Efficacy and safety results from OCTAVIA, a single-arm phase II study evaluating front-line bevacizumab, carboplatin and weekly paclitaxel for ovarian cancer. Eur J Cancer 2013;49:3831-8.