Faculty Collaboration Database

Topotecan in platinum- and paclitaxel-resistant ovarian cancer. Gynecol Oncol 1997 Sep;66(3):480-6

Date

09/23/1997

Pubmed ID

9299264

DOI

10.1006/gyno.1997.4787

Scopus ID

2-s2.0-0031239998 (requires institutional sign-in at Scopus site)   147 Citations

Abstract

OBJECTIVE: The purpose of this study was to define the response rate and toxicity of topotecan in patients with ovarian cancer resistant to first-line therapy.

METHODS: Twenty patients with advanced or recurrent ovarian cancer were enrolled in a phase I/II protocol, and an additional 16 patients were treated following protocol closure at Washington University Medical Center. The starting dose of topotecan was 1.25 mg/m2/day given intravenously over 30 min for 5 consecutive days. Patients were eligible for response evaluation if they completed more than one cycle of topotecan. All patients were evaluated for toxicity.

RESULTS: Of 28 patients eligible for response evaluation, 26 were resistant to both platinum and paclitaxel prior to treatment with topotecan. There were four partial responders and no complete responders for a total response rate of 14% (95% confidence interval: 4 to 33%). All responders had exhibited primary resistance to both platinum and paclitaxel. Myelotoxicity was the major toxicity, with 92% of patients experiencing Gynecologic Oncology Group (GOG) grade 3 or 4 neutropenia and 67% experiencing GOG grade 3 or 4 thrombocytopenia. Other toxicity was minimal and easily managed. Fifty percent of patients receiving more than one cycle of topotecan tolerated a dose equal or greater to the starting dose.

CONCLUSIONS: Topotecan exhibits activity in patients with ovarian cancer resistant to both platinum and paclitaxel. Further study is warranted in less heavily pretreated patients and in combination with other chemotherapeutic agents.

Author List

Swisher EM, Mutch DG, Rader JS, Elbendary A, Herzog TJ

Author

Janet Sue Rader MD Chair, Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Antineoplastic Agents
Antineoplastic Agents, Phytogenic
Antineoplastic Combined Chemotherapy Protocols
Camptothecin
Drug Administration Schedule
Drug Resistance, Multiple
Drug Resistance, Neoplasm
Female
Humans
Middle Aged
Neoplasm Recurrence, Local
Neoplasms, Glandular and Epithelial
Ovarian Neoplasms
Paclitaxel
Platinum Compounds
Survival Analysis
Topotecan
Treatment Outcome