Source: Kardiologiia  |  Posted 8 years ago

By Bonnie Darves

SAN DIEGO, CA -- February 12, 2003 -- Patients with advanced ovarian cancer who have been resistant to platinum therapy have few options for further treatment, but a new regimen involving sequential administration of intraperitoneal topotecan (T) immediately followed by a four-day course of oral etoposide (ET) may evolve as a new approach in salvage therapy. Results of a new study on the sequential timing of the two drugs were reported here February 10th at the Society of Gynecologic Oncologists Annual Meeting.

"The immediate sequential therapy approach may be the best way to combine these two drugs, because when time has elapsed [between administration of T and ET] the topotecan is less efficient," said lead investigator Anil K. Sood, MD, of the M.D. Anderson Cancer Center in Houston, Texas. "You really have to start the second drug immediately, when the levels of the first drug [T] are still high. And the intraperitoneal route allows for less toxicity."

The study involved 23 platinum-resistant Stage III or IV patients with a mean age of 61 years and mean prior history of 1.5 failed treatments over a six-month period. Enrollees received five days of T immediately followed by a four-day course of E. Dosages were 1 mg/m2 over 30 minutes on days 1 through 5 of a 28-day cycle and 100 mg of oral E on days 6 through 9. T was escalated in 0.25 mg increments as tolerated, to a maximum daily dose of 1.5 mg/m2.

The overall response rate to the sequential administration therapy was 38%, and the combination treatment was generally well tolerated, Sood said. Four patients developed febrile neutropaenia requiring hospitalisation, two required platelet transfusions, and one discontinued because of excessive fatigue. Sood noted that despite the small numbers and the uncontrolled structure of the study, the results should be considered "encouraging," given the highly refractory profile of this population, and further studies should be conducted.

[Study title: Sequential Intraperitoneal Topotecan and Oral Etoposide Chemotherapy in Recurrent Platinum-Resistant Ovarian Carcinoma: Results of a Phase II Trial. Abstract 243]