Gupta Divya, Owers Ricky L, Kim Mimi, Kuo Dennis Yi-Shin, Huang Gloria S, Shahabi Shohreh, Goldberg Gary L, Einstein Mark H
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10461, USA.
Gynecol Oncol. 2009 Jun;113(3):327-30. doi: 10.1016/j.ygyno.2009.02.018.
A phase II trial designed to evaluate the safety and efficacy of weekly topotecan and docetaxel in heavily treated patients with recurrent uterine or epithelial ovarian cancers.
Eligible patients with recurrent epithelial ovarian or uterine cancers were treated with weekly topotecan 3.5 mg/m(2) and docetaxel 30 mg/m(2) for 3 consecutive weeks. Cycles were repeated every 4 weeks for 6 cycles or until evidence of disease progression, unacceptable toxicity, or death. Response was assessed as per RECIST or Rustin's criteria. Time to best response and overall survival were calculated using Kaplan-Meier statistical methods.
Twenty-seven patients registered, of which 24 were evaluable for response. The majority of patients had received 2 prior chemotherapy regimens. Of the total 86 cycles of chemotherapy that were administered, there were three grade 4 (all neutropenia) and ten grade 3 toxicities. Six of the grade 3 non-hematologic toxicities were unrelated to treatment. There were 8 dose delays and 4 dose reductions. The overall response rate was 25% (95% CI: 7.7%-42.3%, 8% CR, 17% PR), and 38% of the patients had clinical benefit (95% CI: 18.1%-56.9%; CR+PR+13% SD). The median duration of response was 8.5 months (range 3-19 months). The median overall survival was 18.5 months (range 1.8-50.7 months).
The combination of weekly topotecan and docetaxel has clinical benefit and is well tolerated in this heavily treated patient population. Patients with platinum-resistant tumors had clinical benefit and should be considered for further study with this regimen.
一项II期试验,旨在评估每周使用拓扑替康和多西他赛对接受过大量治疗的复发性子宫癌或上皮性卵巢癌患者的安全性和疗效。
符合条件的复发性上皮性卵巢癌或子宫癌患者接受每周一次拓扑替康3.5mg/m²和多西他赛30mg/m²治疗,连续3周。每4周重复一个周期,共6个周期,或直至出现疾病进展、不可接受的毒性或死亡证据。根据RECIST或Rustin标准评估反应。使用Kaplan-Meier统计方法计算最佳反应时间和总生存期。
27例患者登记入组,其中24例可评估反应。大多数患者之前接受过2种化疗方案。在总共给予的86个化疗周期中,有3例4级毒性(均为中性粒细胞减少)和10例3级毒性。6例3级非血液学毒性与治疗无关。有8次剂量延迟和4次剂量减少。总缓解率为25%(95%CI:7.7%-42.3%,8%完全缓解,17%部分缓解),38%的患者有临床获益(95%CI:18.1%-56.9%;完全缓解+部分缓解+13%疾病稳定)。中位缓解持续时间为8.5个月(范围3-19个月)。中位总生存期为18.5个月(范围1.8-50.7个月)。
每周使用拓扑替康和多西他赛的联合方案在该接受过大量治疗的患者群体中具有临床获益且耐受性良好。铂耐药肿瘤患者有临床获益,应考虑使用该方案进行进一步研究。