Safety and Efficacy of Weekly Paclitaxel and Cisplatin Chemotherapy for Ovarian Cancer Patients with Hypersensitivity to Carboplatin

Background: This study aimed to evaluate the safety and efficacy of weekly paclitaxel and cisplatin chemotherapy (wTP) in patients with ovarian cancer who developed carboplatin hypersensitivity reaction (HSR). Methods: We retrospectively investigated 86 patients with ovarian, fallopian tube, and peritoneal carcinoma who developed carboplatin HSR during previous chemotherapy (carboplatin and paclitaxel) at our institution between 2011 and 2019. After premedication was administered, paclitaxel was administered over 1 h, followed by cisplatin over 1 h (paclitaxel 80 mg/m2; cisplatin 25 mg/m2; 1, 8, 15 day/4 weeks). We investigated the incidence of patients who successfully received wTP for at least one cycle, treatments compliance, progression-free survival (PFS), and overall survival (OS). Results: The median number of wTP administration cycles was 4 (Interquartile Range IQR, 3–7), 71 patients (83%) successfully received wTP, and 15 patients (17%) developed cisplatin HSR. The efficacy of treatment was as follows: 55 (64%) patients completed the scheduled wTP, 9 (10%) patients discontinued due to HSR to cisplatin within 6 cycles, 1 (1%) patient discontinued due to renal toxicity (grade 2) at the 6th cycle, and 21 (24%) patients discontinued due to progressive disease within 6 cycles. The median PFS and OS after administration of wTP were 10.9 months (95% CI: 7.7–17.7) and 25.9 months (95% CI: 19.0–50.2), respectively. Conclusions: wTP was safe and well-tolerated in patients who developed carboplatin HSR.

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The safety and efficacy of weekly paclitaxel and cisplatin chemotherapy for patients with ovarian cancer who developed carboplatin hypersensitivity reaction in previous chemotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.6058 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 6058-6058

Author(s):

Kyoko Nishikimi ◽

Shinichi Tate ◽

Ayumu Matsuoka ◽

Makio Shozu

Keyword(s):

Ovarian Cancer ◽

Sodium Phosphate ◽

Progression Free Survival ◽

Weekly Paclitaxel ◽

First Line ◽

Peritoneal Carcinoma ◽

Free Survival ◽

Safety And Efficacy ◽

Platinum Sensitive ◽

Carboplatin Hypersensitivity

6058 Background: Carboplatin (CBDCA) hypersensitivity reactions (HSR) often occur in patients with ovarian cancer. Once CBACA HSR occurs, it is difficult to use platinum even though the patients had platinum-sensitive disease and consequently the survival of the patients cannot be prolonged. We had administered weekly paclitaxel and cisplatin (CDDP) chemotherapy (wTP) for patients with ovarian cancer who developed CBDCA HSR in previous chemotherapy. We investigated the safety and efficacy of wTP. Methods: We investigated 86 patients with ovarian, fallopian tube, and peritoneal carcinoma who developed CBDCA HSR in previous chemotherapy (paclitaxel/CBDCA) at our institution between 2011 and 2019. After premedication was administered, paclitaxel and sequentially CDDP were administered as one hour infusion, respectively (paclitaxel 80 mg/m2, CDDP 25 mg/m2; 1, 8, 15 day/4 weeks). Results: The median cycle of the previous chemotherapy of CBDCA was 8 (interquartile range [IQR], 6–11). The grade of CBDCA HSR was 1 in 57 (66%), 2 in 26 (30%), and, 3 in 1 (1%) patient(s). WTP was administered for the first line in 21 (24%), second line in 35 (41%) and third or more line in 30 patients (34%). The median cycles of wTP administration was 4 (IQR, 3–7). We observed that severe CDDP HSR did not occur in any patients and 15 patients (17.4%, grade 1, 10 patients; grade 2, 5) developed CDDP HSR. All CDDP HSR were successfully managed with infusion interruption and Hydrocortisone Sodium Phosphate administration. There was no relation between the grade of CBDCA HSR in the previous chemotherapy and the rate of CDDP HSR (p = 0.363). Progression-free survival and overall survival after administration of wTP were 10.9 months (95% CI: 7.7–17.7) and 25.9 months (95%Ci: 19.0–50.2), respectively. Conclusions: 71 patients (82%) who developed CBDCA HSR in previous chemotherapy were able to continue administration of wTP without CDDP HSR. WTP was safe and effective for the patients who developed CBDCA HSR. [Table: see text]

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Combination chemotherapy of intraperitoneal carboplatin and intravenous paclitaxel in suboptimally debulked epithelial ovarian cancer

International Journal of Gynecological Cancer ◽

10.1111/j.1525-1438.2008.01192.x ◽

2008 ◽

Vol 18 (6) ◽

pp. 1210-1214 ◽

Cited By ~ 10

Author(s):

S. Nagao ◽

K. Fujiwara ◽

R. Ohishi ◽

Y. Nakanishi ◽

N. Iwasa ◽

...

Keyword(s):

Ovarian Cancer ◽

Ovarian Carcinoma ◽

Combination Chemotherapy ◽

Progressive Disease ◽

Area Under The Curve ◽

Progression Free Survival ◽

Complete Response ◽

Peritoneal Carcinoma ◽

Free Survival ◽

Grade 3

The objective of this study was to retrospectively assess the efficacy and safety of combination chemotherapy of intraperitoneal (IP) carboplatin and intravenous (IV) paclitaxel in suboptimally debulked ovarian cancer. Between March 1998 and March 2006, 44 patients with histologically confirmed epithelial ovarian carcinoma or peritoneal carcinoma with a residual mass greater than 1 cm received combination chemotherapy of IV paclitaxel and IP carboplatin. Administration of IV paclitaxel at 175 mg/m2 immediately followed by IP carboplatin at an area under the curve of 6 was scheduled every 3 weeks for at least six cycles. The diagnosis and stage were ovarian carcinoma stage II in 8, III in 25, and IV in 6 cases, and peritoneal carcinoma stage III in 5 cases. Eighty-three percent of patients completed more than six cycles of chemotherapy. The incidences of grade 3/4 hematologic toxicities were 41 (93%) for neutrocytopenia, 10 (41%) for thrombocytopenia, and 18 (23%) for anemia. Observed grade 3/4 nonhematologic toxicities were 1 (2%) for allergy, 1 (2%) for fatigue, 1 (2%) for vomiting, 1 (2%) for liver dysfunction, and 4 (9%) for peripheral neuropathy. Two patients (5%) encountered catheter problems (one obstruction and one infection). Overall response rate was 80% (16 complete response, 19 partial response, 3 stable disease, and 6 progressive disease). Median progression-free survival and overall survival were 24 and 31 months, respectively. Combination chemotherapy of IP carboplatin and IV paclitaxel is effective and safe in suboptimally debulked ovarian cancer, and further evaluation is warranted.

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A phase I trial evaluating the safety and efficacy of weekly paclitaxel or cisplatin with electro-hyperthermia in patients with recurrent or persistent epithelial ovarian, fallopian tubal or primary peritoneal carcinoma (KGOG 3030).

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e17032 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e17032-e17032

Author(s):

Kidong Kim ◽

Dong-Hoon Suh ◽

Jae Hong No ◽

Yong Beom Kim ◽

Jae Hoon Kim ◽

...

Keyword(s):

Response Rate ◽

Prospective Trial ◽

Progression Free Survival ◽

Median Number ◽

Oncologic Outcomes ◽

Weekly Paclitaxel ◽

Peritoneal Carcinoma ◽

Safety And Efficacy ◽

Primary Peritoneal Carcinoma ◽

Previous Regimen

e17032 Background: To evaluate the safety and efficacy of weekly paclitaxel or cisplatin with electro-hyperthermia in patients with recurrent or persistent epithelial ovarian, fallopian tubal or primary peritoneal carcinoma. Methods: This prospective trial employed ‘3+3 design’ with no dose escalation. Initially, patients were randomized to weekly paclitaxel (70mg/m2) or weekly cisplatin (40mg/m2) with electro-hyperthermia until three patients in each arm were evaluable for dose-limiting toxicities (DLTs). A cycle was 4 weeks long and paclitaxel or cisplatin was administered at day 1, 8, 15. Targeting tumor beds, electro-hyperthermia was administered semi-weekly (8 time/cycle) for 1 hour per session. DLT was defined as any adverse event possibly or probably related to therapy, that required intensive care or was not recovered to grade 2 or lower within 3 weeks. If ≤1 patient in an arm experienced DLT, additional 3 patients were enrolled to that arm. Unevaluable patients (n = 4) were replaced. Finally, 12 patients (6 in each arm) were evaluated for toxicities, response rate, progression-free survival (PFS) and overall survival (OS). Results: Nine patients had high grade serous histology. Median number of previous regimen was 2 (range 1- 5) and median treatment-free interval from previous chemotherapy was 6 months (range 0 – 27). Nine patients were platinum resistant or refractory. No DLT was observed. Four grade 3 toxicities were observed (nausea 1, hematologic 3) in cisplatin arm. Overall response rate was 42% (5/12), median PFS was 4.3 months (range 1.7 – 11.8), and median OS was over 13.8 months (range 3.9 – > 38.5). Conclusions: Both weekly paclitaxel and cisplatin with electro-hyperthermia are safe enough to be tested in further studies. Chemotherapy with electro-hyperthermia was seems to be an effective treatment strategy for recurrent or persistent epithelial ovarian, fallopian tubal or primary peritoneal carcinomas. No significant differences in oncologic outcomes and toxicities were observed between paclitaxel and cisplatin arms. Clinical trial information: NCT02344095.

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Addition of bevacizumab to weekly paclitaxel significantly improves progression-free survival in heavily pretreated recurrent epithelial ovarian cancer

Gynecologic Oncology ◽

10.1016/j.ygyno.2011.01.009 ◽

2011 ◽

Vol 121 (2) ◽

pp. 269-272 ◽

Cited By ~ 31

Author(s):

David M. O'Malley ◽

Debra L. Richardson ◽

Patrick S. Rheaume ◽

Ritu Salani ◽

Eric L. Eisenhauer ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Progression Free Survival ◽

Weekly Paclitaxel ◽

Free Survival ◽

Heavily Pretreated

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Nonpegylated liposome-encapsulated doxorubicin (NPLED) and cyclophosphamide in the treatment of platinum-resistant ovarian cancer: Final results of a phase II study.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e15544 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e15544-e15544

Author(s):

Daniela Sambataro ◽

Melania Caruso ◽

Concetta Di Blasi ◽

Giuseppe Lavenia ◽

Salvatore Asero ◽

...

Keyword(s):

Ovarian Cancer ◽

Phase Ii ◽

Single Agent ◽

Progression Free Survival ◽

Median Number ◽

Open Label ◽

Open Label Study ◽

Free Survival ◽

Resistant Refractory ◽

Platinum Resistant

e15544 Background: Platinum resistant-refractory ovarian cancer (PRROC) patients have a poor outcome; single-agent therapy is still the gold standard, with overall response rate lesser than 20% and progression-free-survival is not higher than 4 months. Methods: We tested safety and activity of a two-drugs-regimen containing NPLED and cyclophosphamide in a phase II open label study. From October 2007 to October 2011 thirty-two patients with platinum-resistant/refractory disease were enrolled. Enrolled patients were pretreated with a median number of 2 lines of chemotherapy, ranging from 1 to 5. NPLED and cyclophosphamide were administered at the dose of 60 mg. and 600 mg p.s.m. respectively. Results: Patients received a median number of three cycles of chemotherapy. A total of 145 cycles were administered: as G3 toxicities we registered emesis (6%), diaorrhea (3%), asthenia, and alopecia. No grade 4 adverse events occurred. Among the 30 patients evaluable for response we observed 5 (17%) partial responses and 10 (33%) stable diseases. The median progression-free-survival was 13 weeks and the median survival was 46 weeks. Conclusions: These results are similar to other data reported in literature. In conclusion we may affirm that the association of NPLED and cyclophosphamide is active and safe when administered in PRROC, but it don’t modify the prognosis of this subset of patients.

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Real-World Outcome of Platinum-Based Chemotherapy in Advanced Breast Cancer (ABC): A Retrospective Study from a Tertiary Cancer Center in India

Indian Journal of Medical and Paediatric Oncology ◽

10.1055/s-0041-1735597 ◽

2021 ◽

Author(s):

Indhuja Muthiah Vaikundaraja ◽

Manikandan Dhanushkodi ◽

Venkatraman Radhakrishnan ◽

Jayachandran Perumal Kalaiarasi ◽

Nikita Mehra ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Retrospective Study ◽

Progressive Disease ◽

Progression Free Survival ◽

Median Number ◽

Cancer Center ◽

Free Survival ◽

Platinum Based Chemotherapy ◽

Tertiary Cancer Center

Abstract Introduction There is a paucity of data on platinum-based chemotherapy in advanced breast cancer (ABC) from developing countries like India. Objectives The objectives were to analyze the efficacy and safety of platinum-based chemotherapy in patients with ABC. Materials and Methods This was a retrospective study of 35 patients with ABC who were treated with platinum-based chemotherapy (gemcitabine and carboplatin, [GC]) in a tertiary cancer center in India from August 2015 to November 2019. The inclusion criteria were patients with ABC, who had received palliative chemotherapy with GC. The exclusion criteria were patients who had received less than two cycles of GC and patients who received platinum-based chemotherapy for neuroendocrine carcinoma of the breast. Results The median age was 45 years (range: 28–68 years). All patients were female (97%) except one male (3%). The histology was ductal carcinoma (77%), mixed (17%), and others (6%). Out of the 12 patients tested for breast cancer (BRCA) gene mutation, six patients had a BRCA mutation. Patients with metastatic and locally progressive disease were 91 and 9%, respectively. The median number of prior lines of systemic therapy for metastatic disease was 1 (range: 0–5). The median number of sites of metastasis was 2 (range: 0–5). Patients with visceral crises were 23%. The median number of cycles of GC chemotherapy received was 6 (range: 2–6). A dose reduction in chemotherapy was done in 74%. The responses among 34 evaluable patients were complete response (11%), partial response (24%), stable disease (41%), and progressive disease (24%). Grade 3 or more hematological and nonhematological toxicities were observed in 69 and 9%, respectively. The median progression-free survival and overall survival were 6 and 8 months, respectively. The 1-year progression-free survival and overall survival were 19 and 34%, respectively. Multivariate analysis showed that patients who had received more than 3 cycles had a better outcome. Conclusion GC was an active and well-tolerated regimen in ABC regardless of the receptor status. Further prospective randomized studies are warranted to assess the optimal regimen in patients with triple-negative breast cancer.

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Weekly topotecan and biweekly bevacizumab in recurrent and progressive ovarian carcinoma: A single institution experience for third-line or greater treatment.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e16553 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e16553-e16553

Author(s):

Kassondra S Grzankowski ◽

Shashikant B. Lele ◽

John Pietkiewicz

Keyword(s):

Ovarian Cancer ◽

Adverse Events ◽

Progressive Disease ◽

Progression Free Survival ◽

Complete Response ◽

Toxicity Profile ◽

Single Institution ◽

Free Survival ◽

Early Use ◽

Third Line

e16553 Background: The toxicity and efficacy of combined weekly topotecan and weekly bevacizumab in women with recurrent and progressive ovarian cancer. Methods: Reviewed data-base from 1/2003-present (1/2013) identified 15 patients who were treated with topotecan 4mg/m2 on days 1, 8, and 15 and bevacizumab 10mg/kg on days 1 and 15 of a 28-day cycle until progressive disease or excessive toxicity warranted discontinuation. The primary endpoint was progression-free survival. Results: Patients (n = 15) received a median of 4 treatment cycles. Mean number of previous chemotherapy regimens was 5 (range 2-9). Toxicity was generally mild, with neutropenia (20%), gastrointestinal toxicity (20%), pain (26%), anemia requiring transfusion (6%) being the most common adverse events. Two patients required dose adjustment secondary to neutropenia. Patients treated with 5 or more prior regimens had more adverse events, 66% vs. 33%, respectively. No febrile neutropenia or treatment-related deaths occurred. Median PFS and OS were 5.6 months and 5.9 months with 6 (40%) patients progression-free for ≥5 months. Two (13%) patients had complete response, 9 (60%) had stable disease or partial response and were still receiving the above mentioned treatment, and 4 (27%) had progressive disease. Conclusions: Treatment of recurrent and progressive ovarian cancer with weekly Topotecan and biweekly Bevacizumab demonstrates a viable efficacy with acceptable toxicity profile in women with previous multiple lines of treatment; as this becomes a more widely used regimen further investigation will be needed to determine early use of this well tolerated chemotherapy.

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Dose-dense weekly paclitaxel and carboplatin compared with conventional paclitaxel and carboplatin treatment for stage II-IV ovarian cancer patients

Bangladesh Journal of Pharmacology ◽

10.3329/bjp.v10i3.23079 ◽

2015 ◽

Vol 10 (3) ◽

pp. 489

Author(s):

Zhenhua Du ◽

Xiaolin Ma

Keyword(s):

Ovarian Cancer ◽

Cancer Patients ◽

Statistical Significance ◽

Progression Free Survival ◽

Stage Ii ◽

Weekly Paclitaxel ◽

Free Survival ◽

Clinical Responses ◽

Dose Dense ◽

To Receive

<p>We investigated dose-dense weekly paclitaxel and carboplatin compared with conventional paclitaxel and carboplatin treatment on stage II-IV ovarian cancer patients. Between July, 2011, and October, 2014, a total of 221 patients was randomly assigned to receive dose-dense weekly paclitaxel and carboplatin group (n = 109) and conventional paclitaxel and carboplatin group (n = 112), just after the sixth chemotherapy cycles, and at 12 months after randomization. Median progression-free survival (PFS) was 16.8 months (range 3.3-48+ months) of conventional paclitaxel and carboplatin group was lower than that of dose-dense weekly paclitaxel and carboplatin group 27.6 months (range 4.2-51+ months). But, these clinical responses were not statistical significance in each group. In conclusion, dose-dense weekly paclitaxel and carboplatin treatment improves survival compared with conventional paclitaxel and carboplatin treatment. </p>

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