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Combined Doxorubicin/Cisplatin Increases Response Rate In Endometrial Adenocarcinoma
A DGReview of :"Doxorubicin versus doxorubicin and cisplatin in endometrial carcinoma: definitive results of a randomised study (55872) by the EORTC Gynaecological Cancer Group."
Annals of Oncology
03/04/2003
By Elda Hauschildt
Combining doxorubicin with cisplatin produces a significantly higher response rate in patients with endometrial adenocarcinoma than does doxorubicin monotherapy, research from Switzerland indicates.
Investigators from Hopital Cantonal Universitaire in Geneva report a modest survival benefit is achieved, especially in patients who have a good performance status. Median overall survival was nine months in combination therapy patients and seven months in monotherapy patients. They add that toxicity is higher but acceptable with combination therapy.
A total of 177 patients with histologically proven advanced and/or recurrent endometrial adenocarcinoma were enrolled. Median follow-up was 7.1 years. Participants were chemotherapy naïve.
Treatment was administered every four weeks. It was made up of either 60 mg/m² doxorubicin alone or with 50 mg/m² of cisplatin added.
Results indicate 39 patients (43%) receiving doxorubicin/cisplatin responded, including 13 with complete responses and 26 with partial responses. This compared with 15 patients (17%) who responded to doxorubicin monotherapy. A total of eight monotherapy patients were complete responders and seven had partial responses.
Combination therapy was more toxic. White blood cell toxicity grades 3 and 4 occurred in 55% of combination therapy patients and in 30% of monotherapy patients.
There were two main forms of non-haematological toxicity. Grades 3 and 4 alopecia occurred in 72% of combination therapy patients and in 65% of monotherapy patients. Nausea/vomiting was observed in 36% of combination therapy patients and 12% of monotherapy patients.
World Health Organisation performance status was found to be statistically significant as a prognostic factor for survival.
Annals of Oncology, 2003;14:3:441-448.
"Doxorubicin versus doxorubicin and cisplatin in endometrial carcinoma: definitive results of a randomised study (55872) by the EORTC Gynaecological Cancer Group."
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