Topotecan in heavily pretreated patients with recurrent ovarian, peritoneal, and fallopian tube carcinoma

Topotecan has demonstrated antitumor activity in heavily pretreated patients with ovarian carcinoma. This report examines the activity and toxicity of topotecan in 29 heavily pretreated patients with recurrent ovarian, peritoneal, and fallopian tube carcinoma. Topotecan 1.5 mg/m2 was administered intravenously on days 1–5, every 21 days. It was second-line chemotherapy in 6 (20.7%) patients, third-line in 15 (51.7%), fourth-line in 4 (13.8%), fifth-line in 3 (10.3%), and seventh-line in 1 (3.4%). Median dose intensity was 1.667 mg/m2/week, and median relative dose intensity was 0.67. Disease complete response was observed in 5 (17.2%) patients, partial response in 1 (3.4%), stable disease in 12 (41.4%), and progressive disease in 11 (37.9%). CA-125 complete response was observed in 3 (10.3%) patients, partial response in 11 (37.9%), stable level in 5 (17.2%), and progressive level in 9 (31%), and no data were available in 1 (3.4%) patient. Toxicity was mainly hematologic: grade 3–4 neutropenia was observed in 20 (69%) patients, grade 3–4 leukopenia in 12 (41.4%), grade 3–4 thrombocytopenia in 9 (31%), and grade 3–4 anemia in 2 (6.9%). It is concluded that topotecan has considerable activity and noncumulative hematologic toxicity in heavily pretreated patients with recurrent ovarian, peritoneal, and fallopian tube carcinoma.

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Phase II Study of CT-2103 in Patients With Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Carcinoma

Journal of Clinical Oncology ◽

10.1200/jco.2004.12.043 ◽

2004 ◽

Vol 22 (22) ◽

pp. 4523-4531 ◽

Cited By ~ 84

Author(s):

Paul Sabbatini ◽

Carol Aghajanian ◽

Don Dizon ◽

Sybil Anderson ◽

Jakob Dupont ◽

...

Keyword(s):

Fallopian Tube ◽

Recurrent Ovarian Cancer ◽

Median Number ◽

Peritoneal Cancer ◽

Prior Therapy ◽

Platinum Sensitive ◽

Platinum Resistant ◽

Heavily Pretreated ◽

Pretreated Patients ◽

Number Of Cycles

PurposeTo evaluate the safety and efficacy of CT-2103, a novel conjugate of paclitaxel and poly-l-glutamic acid, in heavily pretreated patients with recurrent ovarian, fallopian tube, or peritoneal cancer.Patients and MethodsNinety-nine patients with measurable disease received intravenous CT-2103 at 175 mg/m2of conjugated paclitaxel over 10 minutes every 3 weeks without routine premedications. Platinum-sensitive (n = 42) and platinum-refractory or platinum-resistant patients (n = 57) were enrolled. Thirty-nine patients (39%) had received one or two prior regimens, and 60 patients (61%) had received between three and 12 regimens.ResultsIn 99 patients, the median number of cycles was three (range, one to 14 cycles). The response rate (RR) for all patients was 10% (10 of 99 patients), with median time to disease progression (TTP) of 2 months. The RR (partial response) in platinum-sensitive and platinum-resistant patients was 14% (six of 42 patients) and 7% (four of 57 patients), respectively. In patients with only one or two prior regimens, the RR in platinum-sensitive and platinum-resistant patients was 28% (five of 18 patients) and 10% (two of 21 patients), with a median TTP of 4 and 2 months, respectively. Grade 2 (15 patients) or 3 (15 patients) neuropathy was reported in 30 patients (30%). Grade 2 hypersensitivity occurred in eight patients (8%) who were subsequently treated with premedications; one patient had grade 3 hypersensitivity and was removed. Grade 2 alopecia was absent.ConclusionCT-2103 is active in patients with recurrent ovarian cancer. Neurotoxicity in these heavily pretreated patients was more frequent than predicted from phase I trials. Further study to define toxicity and efficacy in patients with less prior therapy is ongoing.

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Faculty Opinions recommendation of Serous fallopian tube carcinoma: a retrospective, multi-institutional case-control comparison to serous adenocarcinoma of the ovary.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1097253.553271 ◽

2007 ◽

Author(s):

Paola Gehrig

Keyword(s):

Fallopian Tube ◽

Case Control ◽

Fallopian Tube Carcinoma ◽

Serous Adenocarcinoma ◽

Control Comparison ◽

Adenocarcinoma Of The Ovary

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Faculty Opinions recommendation of Vincristine sulfate liposomes injection (Marqibo) in heavily pretreated patients with refractory aggressive non-Hodgkin lymphoma: report of the pivotal phase 2 study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1166037.626930 ◽

2009 ◽

Author(s):

Nicolas Mounier

Keyword(s):

Hodgkin Lymphoma ◽

Phase 2 ◽

Vincristine Sulfate ◽

Pivotal Phase ◽

Non Hodgkin Lymphoma ◽

Phase 2 Study ◽

Heavily Pretreated ◽

Pretreated Patients

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Pegilodecakin as monotherapy or in combination with anti‐PD ‐1 or tyrosine kinase inhibitor in heavily pretreated patients with advanced renal cell carcinoma: Final results of cohorts A, G, H and I of IVY Phase I study

International Journal of Cancer ◽

10.1002/ijc.33556 ◽

2021 ◽

Author(s):

Nizar M. Tannir ◽

Kyriakos P. Papadopoulos ◽

Deborah J. Wong ◽

Raid Aljumaily ◽

Annie Hung ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Tyrosine Kinase ◽

Phase I ◽

Tyrosine Kinase Inhibitor ◽

Cell Carcinoma ◽

Renal Cell ◽

Phase I Study ◽

Kinase Inhibitor ◽

Heavily Pretreated ◽

Pretreated Patients

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Preoperative Sonographic Diagnosis of Primary Fallopian Tube Carcinoma

Journal of Ultrasound in Medicine ◽

10.7863/jum.2002.21.10.1171 ◽

2002 ◽

Vol 21 (10) ◽

pp. 1171-1173 ◽

Cited By ~ 10

Author(s):

Jimmy H. F. Yuen ◽

Grace C. Y. Wong ◽

Christina H. L. Lam

Keyword(s):

Fallopian Tube ◽

Fallopian Tube Carcinoma ◽

Sonographic Diagnosis ◽

Primary Fallopian Tube Carcinoma

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Paclitaxel activity in heavily pretreated breast cancer: a National Cancer Institute Treatment Referral Center trial.

Journal of Clinical Oncology ◽

10.1200/jco.1995.13.8.2056 ◽

1995 ◽

Vol 13 (8) ◽

pp. 2056-2065 ◽

Cited By ~ 85

Author(s):

J S Abrams ◽

D A Vena ◽

J Baltz ◽

J Adams ◽

M Montello ◽

...

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Progressive Disease ◽

Overall Response Rate ◽

Metastatic Breast ◽

Investigational Drug ◽

Single Institution ◽

Doxorubicin Treatment ◽

Heavily Pretreated ◽

Pretreated Patients

PURPOSE To provide paclitaxel, an investigational drug at the inception of this study, to women with chemotherapy-refractory metastatic breast cancer and to evaluate response and toxicity in these patients. PATIENTS AND METHODS Two hundred sixty-seven patients with progressive disease (PD) following at least two chemotherapy regimens for metastatic breast cancer and a contraindication to further doxorubicin treatment received paclitaxel either at 175 mg/m2 intravenously (IV) over 24 hours or at 135 mg/m2 if they had prior irradiation to 30% of marrow-bearing bone or a cumulative dose of mitomycin > or = 20 mg/m2. RESULTS In a subgroup of patients (n = 172) with measurable disease, four complete responses (CRs) and 36 partial responses (PRs) occurred, for an overall response rate of 23% (95% confidence interval [CI], 17% to 30%). No differences in response rates were noted according either to the number of prior chemotherapy regimens received or to whether patients were considered refractory to doxorubicin. The dose and schedule used in this trial resulted in febrile neutropenia in 45% of patients and a hospitalization rate of 49%. CONCLUSION Paclitaxel's activity in this multiinstitutional trial in heavily pretreated patients confirms the encouraging results attained in single-institution trials. Although at this dose and schedule paclitaxel may be considered too myelosuppressive for palliative care, supportive measures such as colony-stimulating factors and antibiotics were not used prophylactically. Current research efforts are focusing on whether paclitaxel's activity against breast cancer is dose- and/or schedule-dependent, and on what role it has in patients with less advanced disease.

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