Rose Peter G, Radeva Milena, Michener Chad M, Link Nicholas, Adbul-Karim Fadi
*Section of Gynecologic Oncology, Women's Health Institute; †Quantitative Health Sciences; ‡Department of Pharmacy; and §Department of Pathology, Cleveland Clinic Healthcare System, Cleveland, OH.
Int J Gynecol Cancer. 2017 Jun;27(5):907-911. doi: 10.1097/IGC.0000000000000977.
The aim of this study was to assess the efficacy of pegylated liposomal doxorubicin (PLD) in low-grade serous ovarian carcinoma (LGSOC).
We retrospectively identified patients with LGSOC who were treated with PLD. Response to therapy was evaluated by RECIST 1.1 criteria. Progression-free survival (PFS) and overall survival were calculated. In addition, PFS on PLD was compared with the patient's most recent PFS on previous therapy.
Twenty-four patients were treated with PLD. Three patients were not evaluable, leaving 21 patients evaluable for response. Pegylated liposomal doxorubicin was dosed at 40 mg/M every 28 days except in 7 patients (5 received PLD dosed at 30 mg/M in combination with carboplatin and 2 received PLD dosed at 20 mg/M, one of which was in combination with etoposide). Four of the patients who received PLD in combination subsequently received PLD alone for 4+, 12, 21, and 29 cycles, respectively. Three patients (14.3%) had a complete response and remained progression free at 8, 31, and 34 months, respectively. Two of these patients received PLD alone. The third complete response patient initially received PLD in combination with carboplatin and then went on to receive PLD alone during which a complete radiologic response was achieved. No difference in response or PFS by platinum sensitivity was noted (Ps = 0.73 and 0.62, respectively). Fourteen patients had stable disease for a median of 18 months. Among the 14 patients with stable disease, the PFS on PLD exceeded the previous PFS in 11 patients (78.6%) from 1.3 to 20.6 folds, with a median of 3.5 folds. The 2 of the 3 lowest increases in PFSs were seen in patients whose therapy was terminated despite stable disease.
Pegylated liposomal doxorubicin is relatively active in LGSOC. The treatment of stable disease resulted in increase in PFS in 78.6% of patients by a mean of 350%.
本研究旨在评估聚乙二醇化脂质体阿霉素(PLD)治疗低级别浆液性卵巢癌(LGSOC)的疗效。
我们回顾性纳入了接受PLD治疗的LGSOC患者。采用RECIST 1.1标准评估治疗反应。计算无进展生存期(PFS)和总生存期。此外,将患者接受PLD治疗的PFS与其之前接受最近一次治疗的PFS进行比较。
24例患者接受了PLD治疗。3例患者无法评估,剩余21例患者可评估治疗反应。聚乙二醇化脂质体阿霉素的给药剂量为每28天40mg/M²,7例患者除外(5例接受30mg/M²的PLD联合卡铂治疗,2例接受20mg/M²的PLD治疗,其中1例联合依托泊苷)。4例接受联合治疗的患者随后分别单独接受了4个以上、12个、21个和29个周期的PLD治疗。3例患者(14.3%)达到完全缓解,分别在8个月、31个月和34个月时仍无进展。其中2例患者单独接受PLD治疗。第3例完全缓解患者最初接受PLD联合卡铂治疗,随后单独接受PLD治疗,并在此期间实现了完全的影像学缓解。未观察到铂敏感性对治疗反应或PFS有差异(分别为Ps = 0.73和0.62)。14例患者病情稳定,中位持续时间为18个月。在这14例病情稳定的患者中,11例患者(78.6%)接受PLD治疗的PFS超过了之前的PFS,为之前的1.3至20.6倍,中位倍数为3.5倍。PFS增长最低的3例患者中有2例尽管病情稳定但治疗仍被终止。
聚乙二醇化脂质体阿霉素在LGSOC中相对有效。78.6%的病情稳定患者接受治疗后PFS平均增加了350%。