Abstract
Background:
Platinum agents have shown demonstrable activity in the treatment of patients with platinum resistant, recurrent ovarian cancer when delivered in a "dose-dense" fashion. However, the development of thrombocytopenia limits the weekly administration of carboplatin to no greater than AUC 2. Paclitaxel has a well-described platelet sparing effect however its use to explicitly provide thromboprotection in the context of dose dense carboplatin has not been explored.
Methods:
We treated seven patients with platinum resistant ovarian cancer who had previously received paclitaxel or who had developed significant peripheral neuropathy precluding the use of further full dose weekly paclitaxel.
Results:
We were able to deliver carboplatin AUC 3 and paclitaxel 20 mg/m2 with no thrombocytopenia or worsening of neuropathic side-effects, and with good activity.
Conclusions:
We conclude that this regimen may be feasible and active, and could be formally developed as a "platinum-focussed dose-dense scaffold" into which targeted therapies that reverse platinum resistance can be incorporated, and merits further evaluation.
Publication types
-
Case Reports
-
Clinical Trial
MeSH terms
-
Adenocarcinoma / blood
-
Adenocarcinoma / drug therapy*
-
Adenocarcinoma / surgery
-
Adenocarcinoma, Papillary / blood
-
Adenocarcinoma, Papillary / drug therapy
-
Adenocarcinoma, Papillary / surgery
-
Aged
-
Aged, 80 and over
-
Antineoplastic Agents, Phytogenic / administration & dosage
-
Antineoplastic Agents, Phytogenic / adverse effects
-
Antineoplastic Agents, Phytogenic / pharmacology*
-
Antineoplastic Combined Chemotherapy Protocols / administration & dosage
-
Antineoplastic Combined Chemotherapy Protocols / adverse effects
-
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
-
Area Under Curve
-
Blood Platelets / drug effects*
-
Carboplatin / administration & dosage
-
Carboplatin / adverse effects
-
Carboplatin / pharmacology*
-
Cisplatin / administration & dosage
-
Combined Modality Therapy
-
Cystadenocarcinoma, Serous / blood
-
Cystadenocarcinoma, Serous / drug therapy
-
Cystadenocarcinoma, Serous / surgery
-
Dose-Response Relationship, Drug
-
Drug Administration Schedule
-
Drug Resistance, Neoplasm
-
Etoposide / administration & dosage
-
Female
-
Granulosa Cell Tumor / blood
-
Granulosa Cell Tumor / drug therapy
-
Granulosa Cell Tumor / surgery
-
Humans
-
Middle Aged
-
Ovarian Neoplasms / blood
-
Ovarian Neoplasms / drug therapy*
-
Ovarian Neoplasms / surgery
-
Ovariectomy
-
Paclitaxel / administration & dosage
-
Paclitaxel / adverse effects
-
Paclitaxel / pharmacology*
-
Peripheral Nervous System Diseases / chemically induced
-
Salvage Therapy*
-
Tamoxifen / administration & dosage
-
Thrombocytopenia / chemically induced
-
Thrombocytopenia / prevention & control*
-
Treatment Outcome
Substances
-
Antineoplastic Agents, Phytogenic
-
Tamoxifen
-
Etoposide
-
Carboplatin
-
Paclitaxel
-
Cisplatin