Korean J Obstet Gynecol.  2008 Jan;51(1):31-40.

The efficacy and toxicity of topotecan in combination with platinum in patients with recurrent epithelial ovarian cancer and primary peritoneal carcinomatosis

• You HJ
• Kim YM
• Lee SW
• Lee JN
• Kim DY
• Suh DS
• Kim JH
• Kim YT
• Nam JH
• Mok JE

Abstract

OBJECTIVE
The aim of this study was to evaluate the efficacy and toxicity of topotecan, camptothecin analogue topoisomerase I inhibitor, as the combination therapy with platinum in patients with recurrent epithelial ovarian carcinoma and primary peritoneal carcinomatosis. METHOD: In this study, patients who were treated with topotecan between January 2000 and June 2007 at Asan Medical Center, Seoul, Korea were reviewed. Fifty-one patients with recurrent ovarian carcinoma and peritoneal carcinomatosis were included. These patients' data were analyzed by review of medical records and pathologic and laboratory reports retrospectively. Response was assessed by Response Evaluation Criteria in Solid Tumors (RECIST) criteria for patients with measurable disease and CA-125 response criteria for patients with non-measurable disease. The toxicities were evaluated according to NCI CTC (Common Toxicity Criteria) version 3.0.
RESULTS
The mean age of patients was 53.4 years (ranged between 37 and 69). Forty-four patients had been evaluated by RECIST criteria. The overall response rate was 22.8% (10/44). Platinum-sensitive patients showed more favorable response rate (26.9%) than platinum-resistant patients (16.7%), however, it was not significant statistically (p=0.425). Platinum-sensitive group had significantly longer response duration (12.14 vs. 3.33 months, p=0.022) and time-to-progression (11.34 vs. 7.33 months, p=0.042) than platinum-resistant group. Heavily pretreated group, three or more prior regimens were used, had no significant differences from another group. The most common adverse effect of topotecan in combination with platinum was hematologic toxicity; grade 3/4 neutropenia was 30.6%, anemia was 42.7%, and thrombocytopenia was 8.37% in total 265 cycles of chemotherapy, however, it was tolerable.
CONCLUSION
Topotecan in combination with platinum is considered as effective regimen with acceptable toxicity in treating recurrent epithelial ovarian carcinoma and primary peritoneal carcinomatosis who have failed previous treatment with platinum-containing chemotherapy.

Keyword

Topotecan; Platinum; Recurrent ovarian cancer; Peritoneal carcinomatosis

MeSH Terms

Anemia
Camptothecin
Carcinoma
DNA Topoisomerases, Type I
Humans
Korea
Medical Records
Neoplasms, Glandular and Epithelial
Neutropenia
Ovarian Neoplasms
Platinum
Retrospective Studies
Thrombocytopenia
Topotecan
Camptothecin
DNA Topoisomerases, Type I
Neoplasms, Glandular and Epithelial
Ovarian Neoplasms
Platinum
Topotecan