Weekly topotecan for recurrent platinum resistant ovarian cancer

• Published in: Gynecologic oncology Vol. 108; no. 1; pp. 53 - 57
• Main Authors: Abushahin, Fadi, Singh, Diljeet K, Lurain, John R, Grendys, Edward C, Rademaker, Alfred W, Schink, Julian C
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2008
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Disease-Free Survival; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Resistance, Neoplasm; Fallopian Tube Neoplasms - drug therapy; Fallopian Tube Neoplasms - pathology; Female; Hematology, Oncology and Palliative Medicine; Humans; Middle Aged; Neoplasm Recurrence, Local - drug therapy; Neoplasm Staging; Obstetrics and Gynecology; Organoplatinum Compounds - pharmacology; Ovarian cancer chemotherapy; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - pathology; Peritoneal Neoplasms - drug therapy; Peritoneal Neoplasms - pathology; Platinum-resistant ovarian cancer; Retrospective Studies; Topotecan - administration & dosage; Topotecan - adverse effects; Weekly topotecan; Weekly topotecan; Platinum-resistant ovarian cancer; Ovarian cancer chemotherapy
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2007.08.062

Abstract Objective. To evaluate toxicity, response and progression-free survival of weekly topotecan chemotherapy in women with primary and secondary platinum-resistant epithelial ovarian cancer. Methods. A retrospective analysis of 69 patients who received weekly topotecan with a median dose of 3.75 on days 1, 8 and 15 of a 28-day cycle treated between November 2002 and May 2005. All patients had recurrent epithelial ovarian, primary peritoneal or tubal cancer with primary or secondary resistance to platinum. Disease response was evaluated by CA-125 levels, physical exam, and when appropriate, imaging studies. Toxicity was evaluated using the NCI Common Toxicity Criteria. Results. Response to topotecan therapy was noted in 14 of 69 patients (20.3%); (complete response 7.3%, and partial response 13%). Stable disease was noted in 23 patients (33.3%) and progression of disease occurred in 31 patients (44.9%). Two patients (2.8%) had significant side effects that warranted discontinuation of therapy. There was no significant difference in response to therapy between patients with primary or secondary platinum resistance. A total of 229 cycles was given with a median of 3 (range 1–12) cycles per patient. Grades 3 and 4 myelosuppression was rare: 1 cycle (0.4%) with grade 3 leukopenia, 16 cycles (7%) with grade 3 or 4 neutropenia, 1 cycle (0.4%) with grade 3 anemia, and 2 cycles (0.9%) with grade 3 thrombocytopenia. No patient was admitted with neutropenic fever. The median progression-free survival for responders was 5.7 months (2–16.75). Conclusions. Weekly topotecan is a well-tolerated and effective regimen for platinum-resistant ovarian cancer with considerable less hematological toxicity when compared with historical data for the 5-day regimen.