Intraperitoneal carboplatin: favorable results in women with minimal residual ovarian cancer after cisplatin therapy

• Published in: Journal of clinical oncology Vol. 8; no. 8; p. 1335
• Main Authors: Speyer, J L, Beller, U, Colombo, N, Sorich, J, Wernz, J C, Hochster, H, Green, M, Porges, R, Muggia, F M, Canetta, R
• Format: Journal Article
• Language: English
• Published: United States 01.08.1990
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - mortality; Adenocarcinoma - physiopathology; Adult; Aged; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Carboplatin; Cisplatin - therapeutic use; Creatinine - metabolism; Drug Evaluation; Female; Follow-Up Studies; Humans; Infusions, Parenteral; Kidney - physiopathology; Middle Aged; Organoplatinum Compounds - administration & dosage; Organoplatinum Compounds - adverse effects; Organoplatinum Compounds - therapeutic use; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - mortality; Ovarian Neoplasms - physiopathology; Peritoneal Cavity; Remission Induction; Survival Rate; Thrombocytopenia - chemically induced
• ISSN: 0732-183X
• DOI: 10.1200/JCO.1990.8.8.1335

From August 1985 to November 1989 we conducted a trial of intraperitoneal (IP) carboplatin including a dose-escalation design in 25 women with advanced gynecologic malignancies. All had extensive prior therapy with cisplatin (median cumulative dose, 525 mg/m2). Carboplatin was administered IP in 2 L of 1.5% dextrose with a 4-hour dwell time every 4 weeks for six cycles at a starting dose of 200 mg/m2. Patients with reduced creatinine clearance (30 to 60 cc/min) were escalated more slowly than those with high (greater than 60 cc/min) clearance. Thrombocytopenia was dose-limiting and often more severe in patients with compromised renal function; there was no local drug toxicity. The median time of follow-up is 25 months. Complete responses (CRs) were documented in six of 23 assessable patients (26%) by repeat laparotomy, and an additional 11 patients (48%) had no disease evident by noninvasive restaging. Five of the CRs and six of the patients with no clinically evident disease have relapsed from 3 to 40 months after therapy. Six patients (26%) are alive and free of disease 8 to 47 (median, 20) months after therapy. IP carboplatin is effective against relapsed ovarian cancer, even after prior cisplatin therapy.