Weekly Dose-Dense Paclitaxel and Triweekly Low-Dose Cisplatin: A Well-Tolerated and Effective Chemotherapeutic Regimen for First-Line Treatment of Advanced Ovarian, Fallopian Tube, and Primary Peritoneal Cancer

Min Cheng, Howard Hao Lee, Wen-Hsun Chang, Na-Rong Lee, Hsin-Yi Huang, Yi-Jen Chen, Huann-Cheng Horng, Wen-Ling Lee and Peng-Hui Wang
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Min Cheng: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112, Taiwan
Howard Hao Lee: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112, Taiwan
Wen-Hsun Chang: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112, Taiwan
Na-Rong Lee: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112, Taiwan
Hsin-Yi Huang: Biostatics Task Force, Taipei Veterans General Hospital, Taipei 112, Taiwan
Yi-Jen Chen: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112, Taiwan
Huann-Cheng Horng: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112, Taiwan
Wen-Ling Lee: Department of Medicine, Cheng-Hsin General Hospital, Taipei 112, Taiwan
Peng-Hui Wang: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112, Taiwan

IJERPH, 2019, vol. 16, issue 23, 1-14

Abstract: A combination of cytoreductive surgery, either primary (PCS) or interval (ICS), and chemotherapy with a platinum-paclitaxel regimen is the well-accepted treatment for advanced-stage epithelial ovarian cancer (EOC), fallopian tube cancer (FTC), and primary peritoneal serous carcinoma (PPSC), but it is still uncertain whether a combination of dose-dense weekly paclitaxel and low-dose triweekly cisplatin is useful in the management of these patients. Therefore, we retrospectively evaluated the outcomes of women with advanced-stage EOC, FTC, and PPSC treated with PCS and subsequent dose-dense weekly paclitaxel (80 mg/m 2 ) and low-dose triweekly cisplatin (20 mg/m 2 ). Between January 2011 and December 2017, 32 women with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC–IV EOC, FTC, or PPSC were enrolled. Optimal PCS was achieved in 63.5% of patients. The mean and median progression-free survival was 36.5 and 27.0 months, respectively (95% confidence interval (CI): 26.8–46.2 and 11.3–42.7 months, respectively). The mean overall survival was 56.0 months (95% CI: 43.9–68.1 months), and the median overall survival could not be obtained. The most common all-grade adverse events (AEs) were anemia (96.9%), neutropenia (50%), peripheral neuropathy (28.1%), nausea and vomiting (34.4%), and thrombocytopenia (15.6%). These AEs were predominantly grade 1/2, and only a few patients were complicated by grade 3/4 neutropenia (21.9%) and anemia (6.3%). A multivariate analysis indicated that only suboptimal PCS was significantly correlated with a worse prognosis, resulting in an 11.6-fold increase in the odds of disease progression. In conclusion, our data suggest that dose-dense weekly paclitaxel (80 mg/m 2 ) combined with low-dose triweekly cisplatin (20 mg/m 2 ) is a potentially effective and highly tolerable front-line treatment in advanced EOC, FTC, and PPSC. Randomized trials comparing the outcome of this regimen to other standard therapies for FIGO stage IIIC–IV EOC, FTC, and PPSC are warranted.

Keywords: dose-dense weekly paclitaxel; epithelial ovarian cancer; fallopian tube cancer; FIGO stage IIIC–IV; low-dose triweekly cisplatin; primary peritoneal serous carcinoma (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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