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吉西他滨联合卡铂治疗铂敏感复发性卵巢癌的II期研究。

A phase II study of gemcitabine plus carboplatin in platinum-sensitive, recurrent ovarian carcinoma.

作者信息

Kose M F, Sufliarsky J, Beslija S, Saip P, Tulunay G, Krejcy K, Minarik T, Fitzthum E, Hayden A, Melemed A

机构信息

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, SSK Maternity and Women's Health Teaching Hospital, Ankara TR-06100, Turkey.

出版信息

Gynecol Oncol. 2005 Feb;96(2):374-80. doi: 10.1016/j.ygyno.2004.10.011.

Abstract

OBJECTIVES

Gemcitabine and carboplatin each have demonstrated effectiveness without increased neurotoxicity in pretreated patients with ovarian cancer. We evaluated the efficacy and safety of gemcitabine plus carboplatin in patients with recurrent ovarian cancer in a multicenter phase II study.

METHODS

Women with histologically proven measurable or evaluable epithelial ovarian cancer (any FIGO) who relapsed > or =6 months after discontinuation of first-line, platinum-containing therapy received gemcitabine 1000 mg/m(2) on days 1 and 8 and carboplatin AUC 4 on day 1 (after gemcitabine) every 21 days for up to six cycles.

RESULTS

Of the 40 enrolled/evaluable patients, 6 (15%) had complete response and 19 (47.5%) had partial response (PR), including one patient with PR in nonmeasurable disease (PRNM), for an overall response rate of 62.5% (95% CI, 45.8-77.3%). The median duration of response was 7.8 months (95% CI, 6.7-10.0), the median time to progressive disease was 9.6 months (95% CI, 8.5-11.0), and the median time to treatment failure was 9.3 months (95% CI, 8.2-10.4). The main grade 3/4 toxicities were neutropenia (78% of patients), leukopenia (30%), thrombocytopenia (18%), and anemia (15%); no grade 4 nonhematologic toxicities occurred, and grade 3 nonhematologic toxicities were mild.

CONCLUSIONS

The combination of gemcitabine and carboplatin is active and feasible in platinum-sensitive patients with recurrent ovarian cancer. This regimen is undergoing further evaluation in a large phase III trial.

摘要

目的

吉西他滨和顺铂在既往接受过治疗的卵巢癌患者中均已显示出有效性,且未增加神经毒性。我们在一项多中心II期研究中评估了吉西他滨联合顺铂治疗复发性卵巢癌患者的疗效和安全性。

方法

组织学确诊为可测量或可评估的上皮性卵巢癌(任何国际妇产科联盟分期)且在停用一线含铂治疗后复发≥6个月的女性患者,每21天接受一次治疗,第1天和第8天给予吉西他滨1000mg/m²,第1天(在吉西他滨之后)给予顺铂AUC 4,共六个周期。

结果

40例入组/可评估患者中,6例(15%)完全缓解,19例(47.5%)部分缓解(PR),包括1例不可测量疾病部分缓解(PRNM)患者,总缓解率为62.5%(95%CI,45.8 - 77.3%)。中位缓解持续时间为7.8个月(95%CI,6.7 - 10.0),中位疾病进展时间为9.6个月(95%CI,8.5 - 11.0),中位治疗失败时间为9.3个月(95%CI,8.2 - 10.4)。主要的3/4级毒性反应为中性粒细胞减少(78%的患者)、白细胞减少(30%)、血小板减少(18%)和贫血(15%);未发生4级非血液学毒性反应,3级非血液学毒性反应较轻。

结论

吉西他滨和顺铂联合方案对铂敏感的复发性卵巢癌患者有效且可行。该方案正在一项大型III期试验中进行进一步评估。

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