What is an appropriate second-line regimen for recurrent endometrial cancer? Ancillary analysis of the SGSG012/GOTIC004/Intergroup study

• Published in: Cancer chemotherapy and pharmacology Vol. 76; no. 2; pp. 335 - 342
• Main Authors: Nagao, Shoji, Nishio, Shin, Okada, Satoshi, Otsuki, Takeo, Fujiwara, Kiyoshi, Tanabe, Hiroshi, Takano, Masashi, Hasumi, Yoko, Takei, Yuji, Hasegawa, Tetsuya, Matsumoto, Takashi, Fujiwara, Keiichi, Takekuma, Munetaka, Nakamura, Kazuto, Shimada, Muneaki, Suzuki, Mitsuaki, Kigawa, Junzo
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2015; Springer Nature B.V
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer Research; Carboplatin - administration & dosage; Cisplatin - administration & dosage; Doxorubicin - administration & dosage; Drug Resistance, Neoplasm; Endometrial Neoplasms - drug therapy; Endometrial Neoplasms - pathology; Female; Humans; Kaplan-Meier Estimate; Medicine; Medicine & Public Health; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - pathology; Oncology; Original Article; Paclitaxel - administration & dosage; Pharmacology/Toxicology; Retrospective Studies; Taxoids - administration & dosage; Second-line chemotherapy; Recurrent endometrial cancer; Platinum sensitivity; AP therapy; TC therapy
• ISSN: 0344-5704; 1432-0843
• DOI: 10.1007/s00280-015-2793-9

Purpose We previously reported that the concept of “platinum sensitivity” could be applied to recurrent endometrial cancer. We conducted an ancillary analysis to determine an appropriate second-line regimen for patients who received a platinum agent as first-line chemotherapy. Methods We extracted and reanalyzed data of patients treated with doxorubicin and cisplatin (AP), paclitaxel and carboplatin (TC), or docetaxel and carboplatin (DC) as first- and second-line chemotherapies from the SGSG012/GOTIC004/Intergroup study. Results We identified 216 patients: 38 received AP as first-line chemotherapy, of which 36 received TC or DC (Tax-C) as second-line chemotherapy; and 178 received Tax-C as first-line chemotherapy, of which 51 received AP and 127 received Tax-C as second-line chemotherapy. Median progression-free survival (PFS) and overall survival (OS) after second-line chemotherapy decreased in the order of Tax-C followed by Tax-C (10 and 48 months, respectively), AP followed by Tax-C (9 and 23 months, respectively), and Tax-C followed by AP (3 and 12 months, respectively). Median PFS and OS after second-line chemotherapy for platinum-resistant patients receiving Tax-C as first-line chemotherapy were longer in Tax-C than in AP (7 and 23 vs. 3 and 10 months, respectively) as second-line chemotherapy [hazard ratio (HR) 3.255, 95 % confidence interval (CI) 1.908–5.555, p  < 0.0001; HR 3.179, 95 % CI 1.835–5.507, p  < 0.0001, respectively]. Median PFS and OS after second-line chemotherapy for platinum-sensitive patients receiving Tax-C as first-line chemotherapy were almost equivalent to those receiving Tax-C or AP as second-line chemotherapy. Conclusions For platinum-resistant recurrent endometrial cancer patients, Tax-C may be preferred over AP as second-line chemotherapy.