Kavanagh J, Tresukosol D, Edwards C, Freedman R, Gonzalez de Leon C, Fishman A, Mante R, Hord M, Kudelka A
Department of Breast and Gynecologic Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
J Clin Oncol. 1995 Jul;13(7):1584-8. doi: 10.1200/JCO.1995.13.7.1584.
To determine the activity of carboplatin in patients with ovarian cancer who progressed on taxane (paclitaxel or docetaxel) therapy.
Thirty-three patients with ovarian cancers refractory to platinum and taxane therapy were treated with single-agent carboplatin reinduction once the disease progressed on a taxane. The starting dose of carboplatin was 300 mg/m2 at 28-day intervals.
Patients were a median age of 56 years (range, 31 to 80), had a median Zubrod performance status of 1 (range, 0 to 2) and had received a median of three prior chemotherapy regimens (range, two to eight) and one pretaxane platinum regimen (range, one to three). Twenty-six patients had a platinum-free interval of at least 12 months at the time of posttaxane re-treatment with carboplatin. There were seven of 33 (21%) partial responses, with a median duration of 7+ months (range, 2+ to 12+). Responses were noted only in patients with at least a 12-month platinum-free interval and an initial sensitivity to a taxane. The therapy was well tolerated and neurotoxicity was absent.
A subset of patients with platinum-refractory disease that initially responded to a taxane and who eventually have a platinum-free interval of at least 1 year may respond to carboplatin reinduction. This finding may be secondary to paclitaxel or docetaxel therapy that leads to the reversal of platinum resistance, or the prolonged platinum-free interval permits the loss of resistance to platinum by the tumor. Carboplatin reinduction should be considered in the treatment of patients whose ovarian cancer progresses after an initial sensitivity to a taxane and who had a prolonged platinum-free interval.
确定卡铂对在紫杉烷（紫杉醇或多西他赛）治疗中病情进展的卵巢癌患者的活性。
33例对铂类和紫杉烷治疗难治的卵巢癌患者，一旦疾病在紫杉烷治疗中进展，就接受单药卡铂再诱导治疗。卡铂起始剂量为300mg/m²，每28天给药一次。
患者的中位年龄为56岁（范围31至80岁），中位Zubrod体能状态为1（范围0至2），既往接受化疗方案的中位数为3个（范围2至8个），紫杉烷治疗前铂类方案的中位数为1个（范围1至3个）。26例患者在紫杉烷治疗后用卡铂再治疗时铂类无治疗间期至少为12个月。33例中有7例（21%）部分缓解，中位缓解持续时间为7+个月（范围2+至12+个月）。仅在铂类无治疗间期至少为12个月且对紫杉烷初始敏感的患者中观察到缓解。该治疗耐受性良好，未出现神经毒性。
一部分对铂类难治的疾病患者，最初对紫杉烷有反应且最终铂类无治疗间期至少为1年，可能对卡铂再诱导有反应。这一发现可能继发于紫杉醇或多西他赛治疗导致铂类耐药逆转，或者延长的铂类无治疗间期使肿瘤对铂类的耐药性丧失。对于卵巢癌在对紫杉烷初始敏感后病情进展且有延长的铂类无治疗间期的患者，治疗中应考虑卡铂再诱导。
