Markman M, Hakes T, Reichman B, Barakat R, Curtin J, Jones W, Lewis J L, Rubin S, Almadrones L, Hoskins W
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Semin Oncol. 1992 Dec;19(6 Suppl 14):25-7.
Despite showing high objective response rates (70% to 80%) to cisplatin- or carboplatin-based chemotherapy, most patients with ovarian cancer ultimately die of complications of their disease. Etoposide, given either as a single agent or in combination with the organoplatinum compounds, has produced disappointingly low response rates in the salvage setting. Based on recent data that suggest chronic administration of oral etoposide is superior to single daily dosing every 3 to 4 weeks, and the failure of previous trials to evaluate etoposide's activity in cisplatin-resistant malignancies, we have begun a phase II trial of chronic, low-dose oral etoposide in patients with clinically defined, platinum-resistant ovarian cancer. Thus far, 11 patients have been entered into the study. Neutropenia, the most prevalent toxicity, has precluded several patients from receiving the full 20-day course of 50 mg/d. No responses to treatment have been observed in nine evaluable patients. The study continues to accrue patients. The final results of this study and other trials should help determine the efficacy of chronic low-dose oral etoposide administration in patients with ovarian cancer.
尽管基于顺铂或卡铂的化疗显示出较高的客观缓解率（70%至80%），但大多数卵巢癌患者最终死于疾病并发症。依托泊苷无论是单药使用还是与有机铂化合物联合使用，在挽救治疗中的缓解率都低得令人失望。基于近期数据表明长期口服依托泊苷优于每3至4周单次每日给药，且既往试验未能评估依托泊苷在顺铂耐药恶性肿瘤中的活性，我们开展了一项针对临床确诊的铂耐药卵巢癌患者的长期低剂量口服依托泊苷的II期试验。迄今为止，已有11名患者入组该研究。中性粒细胞减少是最常见的毒性反应，导致数名患者无法接受50mg/d的完整20天疗程治疗。在9名可评估患者中未观察到治疗反应。该研究仍在继续招募患者。本研究及其他试验的最终结果应有助于确定长期低剂量口服依托泊苷治疗卵巢癌患者的疗效。
