Taxol-Carboplatin regimen as Salvage Therapy in Patients with recurrent or drug-refractory Ovarian Cancer after Failure of Platinum based Chemotherapy

Jang, J Y; Jang, K T; Kang, J M; Park, S K; Bae, D H

Abstract

The purpose of this study is to assess the efficacy and toxicity of Taxol used as a salvage therapy in patients with recurrent or drug-refractory ovarian cancer. Nonrandomized, clinical trial of patients with recurrent or drug-refractory ovarian cancer. recurrent ovarian cancer was undertaken. Twelve patients aged 35~71 years (median 61) with recurrent or drug-refractory ovarian carcinoma were given Taxol-containing regimen. Taxol was administered at a dose of 175 mg/m2. intravenously with Carboplatin (400 mg/m2) every 21 days. The median treatment cycle was 5.4 cycles (range, 3 to 9 cycles). A premedication regimens (Dexamethasone 40mg # 2 IM, Diphenhydramine 50 mg IV, Cimetidine 300 mg IV) were used to avoid acute hypersensitivity reactions. The response of patients were evaluated with tumor markers (CA-125, CEA) and CT or MRI before and after chemotherapy. Responses and toxicities were defined according to the Gynecologic Oncology Group (GOG) criteria. The overall response rate was 25% (3/12), including 1 complete response (CR) and 2 partial response (PR). The most common severe toxicity was leukopenia, with grade 2 toxicity ocurring in 65% of the courses; grade 4 leukopenia occuring in 16% of the courses. Other hematologic toxicities were anemia and thrombocytopenia, but no grade 4 these severe toxicities were noted. We observed 25% response rate with taxol for patients with drug-refractory or recurrent ovarian cancer. Taxol is the active drug in advanced ovarian cancer, numerous reports of unequivocal antineoplastic effect of Taxol, but has limited role in refractory or relapsing cases. Further study is required to evaluate the optimal dose of Taxol or combination with other agent in the management of advanced ovarian cancer.