Ferrero J-M, Weber B, Geay J-F, Lepille D, Orfeuvre H, Combe M, Mayer F, Leduc B, Bourgeois H, Paraiso D, Pujade-Lauraine E
Centre Antoine Lacassagne, Nice, France.
Ann Oncol. 2007 Feb;18(2):263-8. doi: 10.1093/annonc/mdl376. Epub 2006 Nov 15.
Platinum-based chemotherapy is standard second-line treatment of patients with advanced ovarian cancer (AOC) in late relapse. Pegylated liposomal doxorubicin (PLD) has significant single-agent activity in this setting. Therefore, we evaluated the use of PLD plus carboplatin in this patient population.
PLD 30 mg/m(2) followed by carboplatin at area under the curve (AUC) 5 mg.min/ml, repeated every 28 days for a maximum of nine cycles, was administered to 104 women with AOC relapsing >or=6 months after completion of first- or second-line therapy with platinum-taxane-based regimens.
Overall response was 63%, with a 38% complete response, median progression-free survival of 9.4 months, and median overall survival (OS) of 32 months. Grade 3 or 4 neutropenia occurred in 51% of patients, but febrile neutropenia in only 3%. Nonhematologic toxic effects were primarily grades 1 and 2, with low rates of alopecia and neurotoxicity.
PLD plus carboplatin is highly effective, prolongs OS, and is well tolerated in women with AOC in late relapse previously treated with both platinum and taxanes. Evaluation of this regimen in phase III trials is warranted.
铂类化疗是晚期复发的晚期卵巢癌(AOC)患者的标准二线治疗方案。聚乙二醇化脂质体阿霉素(PLD)在这种情况下具有显著的单药活性。因此,我们评估了PLD联合卡铂在该患者群体中的应用。
对104例在完成基于铂-紫杉烷方案的一线或二线治疗后复发≥6个月的AOC女性患者,给予PLD 30mg/m²,随后给予卡铂,曲线下面积(AUC)为5mg·min/ml,每28天重复一次,最多九个周期。
总缓解率为63%,完全缓解率为38%,中位无进展生存期为9.4个月,中位总生存期(OS)为32个月。51%的患者发生3级或4级中性粒细胞减少,但发热性中性粒细胞减少仅为3%。非血液学毒性主要为1级和2级,脱发和神经毒性发生率较低。
PLD联合卡铂疗效显著,可延长OS,对于先前接受过铂类和紫杉烷类治疗的晚期复发AOC女性患者耐受性良好。有必要在III期试验中评估该方案。