Outpatient platinum-taxane intraperitoneal chemotherapy regimen for ovarian cancer. 2009

Leigh G Seamon, and Matthew J Carlson, and Debra L Richardson, and David E Cohn, and Jeffrey M Fowler, and Larry J Copeland, and David M O'Malley
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine and Arthur G James Cancer Hospital and Solove Research Institute, Columbus, OH 43210-1228, USA.

BACKGROUND Intraperitoneal (IP) chemotherapy is associated with an improved survival at the expense of increased toxicity in optimally debulked ovarian cancer patients. We describe the toxicity profile of an outpatient regimen of an intravenous (IV) and IP taxane-platinum chemotherapy. METHODS A chart review of all patients who received IP chemotherapy from December 2005 to May 2008 was performed. Optimally debulked patients after primary surgery for ovarian, primary peritoneal, or fallopian tubal cancer who received IV docetaxel 60 to 70 mg/m and IP cisplatin 80 to 85 mg/m on day 1 and IP paclitaxel 60 to 70 mg/m on day 8 every 21 days were included. Toxicities were recorded using the Common Terminology Criteria for Adverse Events v3.0. RESULTS Thirty-three patients have completed chemotherapy. Of these, 19 patients (58%) completed all planned cycles of IP chemotherapy and 23 (70%) completed 75% or greater of the planned cycles. Four patients (12%) did not complete 50% or greater of the cycles. A total of 150.5 IP cycles were delivered, with a median number of 4 IP cycles (range, 0.5-7.5) completed. Grades 3 and 4 hematologic toxicities occurred in 21% of patients (n = 7), and 8 patients (24%) experienced grade 3 or 4 nonhematologic events. The overall response rate was 100% (complete response, 91%; partial response, 9.0%) with a progression-free survival of 19 months. CONCLUSIONS This outpatient regimen of IV and IP platinum-taxane chemotherapy is well tolerated with acceptable toxicity. Importantly, most patients were able to complete all planned cycles of chemotherapy. These findings suggest that continued investigation of methods to decrease the toxicity of the treatment seen in the Gynecologic Oncology Group Protocol 172 is needed and should be studied in future phase 2 IP chemotherapy trials.

UI MeSH Term Description Entries
D007274 Injections, Intraperitoneal Forceful administration into the peritoneal cavity of liquid medication, nutrient, or other fluid through a hollow needle piercing the abdominal wall. Intraperitoneal Injections,Injection, Intraperitoneal,Intraperitoneal Injection
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010045 Outpatients Persons who receive ambulatory care at an outpatient department or clinic without room and board being provided. Out-patients,Out patients,Out-patient,Outpatient
D010051 Ovarian Neoplasms Tumors or cancer of the OVARY. These neoplasms can be benign or malignant. They are classified according to the tissue of origin, such as the surface EPITHELIUM, the stromal endocrine cells, and the totipotent GERM CELLS. Cancer of Ovary,Ovarian Cancer,Cancer of the Ovary,Neoplasms, Ovarian,Ovary Cancer,Ovary Neoplasms,Cancer, Ovarian,Cancer, Ovary,Cancers, Ovarian,Cancers, Ovary,Neoplasm, Ovarian,Neoplasm, Ovary,Neoplasms, Ovary,Ovarian Cancers,Ovarian Neoplasm,Ovary Cancers,Ovary Neoplasm
D002945 Cisplatin An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. Platinum Diamminodichloride,cis-Diamminedichloroplatinum(II),cis-Dichlorodiammineplatinum(II),Biocisplatinum,Dichlorodiammineplatinum,NSC-119875,Platidiam,Platino,Platinol,cis-Diamminedichloroplatinum,cis-Platinum,Diamminodichloride, Platinum,cis Diamminedichloroplatinum,cis Platinum
D004334 Drug Administration Schedule Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience. Administration Schedule, Drug,Administration Schedules, Drug,Drug Administration Schedules,Schedule, Drug Administration,Schedules, Drug Administration
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077143 Docetaxel A semisynthetic analog of PACLITAXEL used in the treatment of locally advanced or metastatic BREAST NEOPLASMS and NON-SMALL CELL LUNG CANCER. Docetaxel Anhydrous,Docetaxel Hydrate,Docetaxel Trihydrate,Docetaxol,N-Debenzoyl-N-tert-butoxycarbonyl-10-deacetyltaxol,NSC 628503,RP 56976,RP-56976,Taxoltere Metro,Taxotere,N Debenzoyl N tert butoxycarbonyl 10 deacetyltaxol,RP56976
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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