Comparison of the efficacy between topotecan- and belotecan-, a new camptothecin analog, based chemotherapies for recurrent epithelial ovarian cancer: A single institutional experience

• Published in: The journal of obstetrics and gynaecology research Vol. 36; no. 1; pp. 86 - 93
• Main Authors: Kim, Hee Seung, Park, Noh Hyun, Kang, Sokbom, Seo, Sang-Soo, Chung, Hyun Hoon, Kim, Jae Weon, Song, Yong Sang, Kang, Soon-Beom
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.02.2010
• Subjects: Adult; Aged; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; belotecan; Camptothecin - administration & dosage; Camptothecin - adverse effects; Camptothecin - analogs & derivatives; Camptothecin - therapeutic use; Carcinoma - drug therapy; Cisplatin - administration & dosage; epithelial ovarian cancer; Epithelium; Female; Humans; Middle Aged; Neoplasm Recurrence, Local - drug therapy; Ovarian Neoplasms - drug therapy; recurrent; Retrospective Studies; Survival Analysis; Topotecan; Topotecan - administration & dosage; Topotecan - adverse effects; Topotecan - therapeutic use
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/j.1447-0756.2009.01101.x

Aim:  To compare the efficacy and toxicity between topotecan‐ and belotecan‐based chemotherapies in recurrent epithelial ovarian cancer (EOC). Methods:  The clinical data of 80 patients treated with topotecan‐ (n = 45) or belotecan‐ (n = 35) based chemotherapy as at least a second‐line chemotherapy were reviewed retrospectively between July 2001 and December 2007. Response was evaluated using the Response Evaluation Criteria in Solid Tumours (RECIST) and serum CA‐125 levels. Hematological toxicity was examined according to the National Cancer Institute Common Toxicity Criteria (NCI‐CTC) version 2.0. Time to progressive disease (TTPD), chemotherapy‐specific survival (CSS) and overall survival (OS) according to the 2 chemotherapies were evaluated by the Kaplan‐Meier analysis with the log‐rank test. Results:  Overall response rate (ORR) was 24.4% in patients treated with topotecan‐based chemotherapy, while it was 45.7% in those treated with belotecan‐based chemotherapy (P = 0.046). Moreover, ORR was higher in platinum‐sensitive patients treated with belotecan‐based chemotherapy (58.8%) than those treated with topotecan‐based chemotherapy (22.2%) (P = 0.041) although it was not significantly different in platinum‐resistant patients (P = 0.471). Grade 3 or 4 anemia, neutropenia and thrombocytopenia developed in 14.8% vs 3.6%, 43.1% vs 55.6%, and 20.0% vs 12.8% of cycles in topotecan‐ and belotecan‐based chemotherapies, respectively (P < 0.05). There were no significant difference in survival between the 2 chemotherapies. Conclusions:  In our experience, belotecan‐based chemotherapy seemed to be efficient with acceptable toxicity, compared to topotecan‐based chemotherapy in recurrent EOC. However, randomized controlled trials are required for the comparison of the efficacy and toxicity between topotecan‐ and belotecan‐based chemotherapies in recurrent EOC.