Response to Salvage Treatment in Recurrent Ovarian Cancer Treated Initially with Paclitaxel and Platinum-Based Combination Regimens

• Published in: Gynecologic oncology Vol. 68; no. 2; pp. 178 - 182
• Main Authors: Roland, P.Y., Barnes, M.N., Niwas, S., Robertson, M.W., Alvarez, R., Austin, J.M., Kilgore, L.C., Partridge, E.E.
• Format: Journal Article
• Language: English
• Published: San Diego, CA Elsevier Inc 01.02.1998; Elsevier
• Subjects: Adult; Aged; Antineoplastic agents; Antineoplastic Agents, Alkylating - administration & dosage; Antineoplastic Agents, Phytogenic - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Carboplatin - administration & dosage; Chemotherapy; Cisplatin - administration & dosage; Disease-Free Survival; Female; Humans; Medical sciences; Middle Aged; Neoplasm Staging; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - pathology; Paclitaxel - administration & dosage; Pharmacology. Drug treatments; Recurrence; Remission Induction; Retrospective Studies; Salvage Therapy; Treatment Outcome; Antineoplastic agent; Human; Drug combination; Relapse; Malignant tumor; Cisplatin; Female genital diseases; Result; Ovarian diseases; Ovary; Chemotherapy; Treatment; Taxane derivatives; Paclitaxel; Female; Antimitotic; Platinum II Complexes
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1006/gyno.1997.4909

Objective.The aim of this study was to evaluate the response to salvage treatment in recurrent ovarian cancer treated initially with paclitaxel-based chemotherapy. Methods.A retrospective review of patients with recurrent ovarian cancer treated with surgical debulking and paclitaxel-based chemotherapy was performed. All cases received second-line treatment with a response evaluated by clinical or surgical means. Data analysis was conducted using the SAS statistical package. Results.Fifty cases of advanced stage disease were available for review. Patients received paclitaxel and cisplatin or carboplatin with a 72.0% response rate. The median time to recurrence after primary treatment was 6 months. Second-line treatment included cisplatin or carboplatin (50%), Taxol (10%), or lutetium (22%), an intraperitoneal radiolabeled monoclonal antibody targeted to TAG-72. A 52.0% clinical response to salvage treatment was detected. With a median follow-up of 7 months, 68.0% of patients had experienced recurrence or progression of their disease. The median time to second recurrence was 5 months. Cases sensitive to initial paclitaxel-containing chemotherapy responded to any of the salvage treatments more frequently than chemotherapy-resistant tumors (88.5% versus 11.5%,P< 0.05). Conclusions.Recurrent ovarian cancer patients initially treated with paclitaxel-based chemotherapy frequently responded to salvage treatment. However, the duration of response was brief, and hospitalization for treatment-related side-effects was common. Tumor response to initial paclitaxel/platinum treatment was predictive of future response to second-line agents. Current salvage therapies appear to provide little benefit in cases of tumors resistant to primary chemotherapy.