Francis P, Schneider J, Hann L, Balmaceda C, Barakat R, Phillips M, Hakes T
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY.
J Clin Oncol. 1994 Nov;12(11):2301-8. doi: 10.1200/JCO.1994.12.11.2301.
This phase II study was conducted to evaluate the efficacy and toxicity of docetaxel in the treatment of patients with platinum-refractory ovarian cancer.
Twenty-five patients with platinum-refractory advanced ovarian cancer were treated. Twenty of the patients had failed to respond to platinum-based front-line chemotherapy and five had failed to respond to platinum-based therapy repeated at relapse. One patient had received prior pelvic radiation therapy. Patients were required to have bidimensionally measurable disease. Docetaxel was administered at a dose of 100 mg/m2 intravenously (i.v.) over 1 hour every 21 days. Twenty patients received no corticosteroid premedication and five received premedication with corticosteroids and antihistamines.
Eight of 23 assessable patients (35%) had a partial response (PR; 95% confidence interval, 16% to 57%). The median response duration was 5 months. Hospitalization for toxicity, predominantly neutropenic fever, occurred in 12 patients (48%) and 16% of courses. Anemia was common in the study population. Nonhematologic toxicities included alopecia, rash, fluid retention, diarrhea, peripheral neuropathy, and hypersensitivity reactions.
Docetaxel demonstrates significant activity in patients with platinum-refractory advanced ovarian cancer. Routine premedication is recommended. Further investigations of this agent in ovarian cancer, including combinations with other active agents, appear indicated.
本II期研究旨在评估多西他赛治疗铂类难治性卵巢癌患者的疗效和毒性。
对25例铂类难治性晚期卵巢癌患者进行了治疗。其中20例患者对铂类一线化疗无反应,5例患者在复发时对铂类治疗重复无反应。1例患者曾接受过盆腔放疗。患者需有可进行二维测量的病灶。多西他赛以100mg/m²的剂量静脉滴注1小时,每21天1次。20例患者未接受皮质类固醇预处理,5例患者接受了皮质类固醇和抗组胺药预处理。
23例可评估患者中有8例(35%)获得部分缓解(PR;95%置信区间,16%至57%)。中位缓解持续时间为5个月。12例患者(48%)因毒性住院,主要是中性粒细胞减少性发热,占疗程的16%。贫血在研究人群中很常见。非血液学毒性包括脱发、皮疹、液体潴留、腹泻、周围神经病变和过敏反应。
多西他赛在铂类难治性晚期卵巢癌患者中显示出显著活性。建议进行常规预处理。该药物在卵巢癌中的进一步研究,包括与其他活性药物联合使用,似乎是有必要的。