Karagol Hakan, Saip Pinar, Uygun Kazim, Caloglu Murat, Eralp Yesim, Tas Faruk, Aydiner Adnan, Topuz Erkan
Department of Medical Oncology, Faculty of Medicine, Trakya University, Turkey.
Med Oncol. 2007;24(1):39-43. doi: 10.1007/BF02685901.
Activity of tamoxifen as a salvage therapy in patients with advanced epithelial ovarian cancer was evaluated by a number of studies. In this study, we evaluated efficacy of tamoxifen in our patients with platinum-resistant epithelial ovarian carcinoma.
A retrospective analysis was conducted of patients who received tamoxifen at a dose 20 mg twice daily for the treatment of advanced epithelial ovarian cancer.
Twenty-nine eligible patients were included to the study. There were 1 (3%) complete response, 2 (7%) partial response, 6 (21%) stable disease, and 20 (69%) progressive disease. All patients were progressed after initiation of tamoxifen. Median progression-free survival was 4 mo (95% CI: 2.98-5.02). Disease progression of 19 (65%) patients were shown within the first 6 mo after initiation of tamoxifen. Progression-free survival was between 6 and 12 mo for 7 (24%) patients and > or =12 mo for 3 (10%) patients. The median survival after initiation of tamoxifen was 15 mo (95% CI: 7.2-22.8). No toxicity attributable to tamoxifen was seen in any of the patients. The only independent prognostic factor that had a significant predictive value for progression- free survival was the response to tamoxifen treatment (p = 0.043, hazard ratio: 0.12, 95% CI: 0.01-0.94).
Considering minimal side effects and ability to cause objective responses, there is a place for tamoxifen in treatment of patients with platinum-resistant ovarian cancer. A phase III trial is required to con- firm the value of the drug in patients presenting these clinical settings.
多项研究评估了他莫昔芬作为晚期上皮性卵巢癌挽救治疗的活性。在本研究中,我们评估了他莫昔芬对铂耐药上皮性卵巢癌患者的疗效。
对接受他莫昔芬每日两次、每次20mg治疗晚期上皮性卵巢癌的患者进行回顾性分析。
29例符合条件的患者纳入研究。有1例(3%)完全缓解,2例(7%)部分缓解,6例(21%)疾病稳定,20例(69%)疾病进展。所有患者在开始使用他莫昔芬后均出现疾病进展。无进展生存期的中位数为4个月(95%置信区间:2.98 - 5.02)。19例(65%)患者在开始使用他莫昔芬后的前6个月内出现疾病进展。7例(24%)患者的无进展生存期在6至12个月之间,3例(10%)患者的无进展生存期≥12个月。开始使用他莫昔芬后的中位生存期为15个月(95%置信区间:7.2 - 22.8)。在任何患者中均未观察到归因于他莫昔芬的毒性。对无进展生存期具有显著预测价值的唯一独立预后因素是对他莫昔芬治疗的反应(p = 0.043,风险比:0.12,95%置信区间:0.01 - 0.94)。
考虑到副作用极小且能引起客观反应,他莫昔芬在铂耐药卵巢癌患者的治疗中占有一席之地。需要进行一项III期试验来证实该药物在这些临床情况下对患者的价值。