Haematological evaluation of weekly therapy with topotecan for the treatment of recurrent ovarian cancer resistant to platinum-based therapy

Oncology. 2007;73(3-4):177-84. doi: 10.1159/000127384. Epub 2008 Apr 16.

Abstract

Topotecan is indicated in the treatment of advanced-stage ovarian cancers refractory to prior platinum-based regimen. The aim of this study was to compare the standard therapeutic strategy with a novel strategy of weekly administration of topotecan. The primary endpoints were dose density and overall tolerance. This retrospective cohort study included patients with ovarian cancer in relapse. During a first period (1998-2001), 24 patients received the standard topotecan dose of 1.5 mg/m(2)/day for 5 consecutive days with a 3-week interval between each treatment course. During a second period (2003-2006), 21 patients received a weekly topotecan dose of 4 mg/m(2) for 3 weeks out of every 4. Grades III and IV haematological toxicities were more frequent with the standard strategy (p < 0.05), even after adjustment of the prescription of erythropoietin and G-CSF. With the weekly strategy, an increase in dose density and a reduction in the number of delayed doses were observed. No significant difference between the 2 strategies was found in terms of response to the treatment and specific survival. This study suggests that the weekly administration of topotecan 4 mg/m(2), for 3 weeks out of every 4, results in a better maintenance of dose density and a reduction in haematological toxicity.

MeSH terms

  • Adenocarcinoma, Clear Cell / drug therapy
  • Adenocarcinoma, Clear Cell / secondary
  • Adenocarcinoma, Mucinous / drug therapy
  • Adenocarcinoma, Mucinous / secondary
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Cohort Studies
  • Cystadenocarcinoma, Serous / drug therapy
  • Cystadenocarcinoma, Serous / secondary
  • Dose-Response Relationship, Drug
  • Drug Resistance, Neoplasm*
  • Endometrial Neoplasms / drug therapy
  • Endometrial Neoplasms / secondary
  • Female
  • Hematologic Diseases / chemically induced
  • Hematologic Diseases / prevention & control
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / pathology
  • Organoplatinum Compounds / therapeutic use*
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / pathology
  • Retrospective Studies
  • Survival Rate
  • Topotecan / adverse effects
  • Topotecan / therapeutic use*
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Organoplatinum Compounds
  • Topotecan