Platinum – sensitive relapsed epithelial ovarian cancer: Not all the patients benefit from reinduction with carboplatin and paclitaxel
Marijana Milovic-Kovacevic, Ljiljana Stamatovic, Ivan Popov, Ljiljana Radosevic-Jelic, Iva Kezic
Med Sci Monit 2010; 16(11): CR549-554
Available online: 2010-11-01
Background: It is widely accepted that patients with ovarian cancer relapsing 6 to 12 months after completion of a platinum-based regimen are considered to be partially platinum-sensitive. The aim of this study was to evaluate and correlate the efficacy and toxicity of reinduction with paclitaxel-carboplatin in a platinum-sensitive epithelial ovarian cancer patient cohort with previous platinum-free interval (PFI).
Material/Methods: We studied retrospectively 39 patients with platinum-sensitive epithelial ovarian cancer, who received primary chemotherapy at the Institute for Oncology and Radiology of Serbia, between January 2002 and May 2008. All patients were treated with paclitaxel and carboplatin for metastatic disease. Subsequent to progression, patients were re-treated with the same chemotherapy in group A (PFI 6–12 months) or group B (PFI ≥12 months).
Results: The number of patients in group A was 14, and in group B it was 25. Response rate to reinduction in group A was 36% (partial response, 36%; stable disease, 0%; progressive disease, 64%) and in group B was 68% (complete response, 60%; partial response, 8%; stable disease, 4%; progressive disease, 28%; P=.05). The median response duration of the patients in group A arm was 20 months, whereas it was 17 months for those in group B (P=.721). There were no significant differences in the toxicity profile between the 2 groups.
Conclusions: In terms of objective response rate this study supports the reinduction of carboplatin and paclitaxel in patients with a prior PFI of at least 12 months only. To define the best approach and the optimal treatment of patients with partially platinum-sensitive disease more precisely, future studies should apply treatment-free interval as a stratification criterion.
Keywords: Recurrence, Remission Induction, Paclitaxel - toxicity, Ovarian Neoplasms - pathology, Neoplasm Metastasis - drug therapy, Carboplatin - toxicity, Antineoplastic Agents, Phytogenic - toxicity, Survival Rate