Duration of Chemotherapy with Topotecan Influences Survival in Recurrent Ovarian Cancer: A Meta-analysis

• Published in: Anticancer research Vol. 27; no. 3B; pp. 1581 - 1588
• Main Authors: MOBUS, Volker, KIEBACK, Dirk G, KAUBITZSCH, Sabine K
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01.05.2007
• Subjects: Adult; Aged; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Biological and medical sciences; Clinical Trials as Topic; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - mortality; Ovarian Neoplasms - drug therapy; Retrospective Studies; Survival; Topotecan - administration & dosage; Topotecan - adverse effects; Treatment Outcome; Tumors; Antineoplastic agent; Relapse; Enzyme; ovarian cancer; Ovary cancer; DNA topoisomerase; Enzyme inhibitor; meta-analysis; Topotecan; Malignant tumor; Long term; Survival; Female genital diseases; Metaanalysis; Ovarian diseases; Chemotherapy; Isomerases; Cancerology; Treatment; maintenance; long-term
• ISSN: 0250-7005; 1791-7530

Objective: This meta-analysis compares the feasibility, safety and clinical outcome of long-term therapy with topotecan vs. standard treatment duration in patients with recurrent ovarian cancer. Materials and Methods: Data of 523 patients from five clinical trials were reviewed and retrospectively allocated into two groups. Those patients who received 6 or fewer courses were compared to those with 7 or more courses of intravenous topotecan. Response rates, overall survival and toxicity profiles were compared between these groups. Results: One hundred and fifty-two (29%) patients received 7 or more courses and 371 patients (71%) received up to 6 courses of topotecan. Hematological toxicity was significant but similar in both treatment groups and was not cumulative. Non-hematological toxicity was generally mild. Eighty-seven (17%) patients responded to topotecan treatment, 66 of these patients received 7 or more courses of therapy. In total, 14 patients experienced their initial response at or after course 6 of therapy. Within the subset of patients with response or disease stabilization at course 6, those who stopped treatment at course 6 for reasons other than progressive disease or adverse events had a median survival of 83.6 weeks and those who continued treatment for longer than 6 courses had a significantly longer median survival of 107.0 weeks. Conclusion: Chemotherapy with 7 or more courses of topotecan in recurrent ovarian cancer is feasible with no evidence of cumulative toxicity. The results of this retrospective analysis suggest a potential for late response and a survival benefit for those patients without disease progression who continue topotecan therapy beyond 6 cycles of treatment.