Altretamine (hexamethylmelamine) in the treatment of platinum-resistant ovarian cancer: a phase II study

Gynecol Oncol. 2003 Feb;88(2):118-22. doi: 10.1016/s0090-8258(02)00103-8.

Abstract

Objective: To evaluate the activity of oral Altretamine in women with epithelial ovarian carcinoma who responded (PR or CR) to first line chemotherapy but relapsed within 6 months. The protocol was later amended to include patients with relapse within 12 months.

Methods: A multicentric phase II trial. The patients had to have measurable disease. No more than one prior chemotherapy regiment was allowed. The patients were treated with 260 mg/m(2)/day of Altretamine in four divided doses for 2 weeks, repeated every 4 weeks. The response was evaluated after every two courses.

Results: Thirty-one eligible patients were treated with a median of 3 courses of Altretamine (range 1-12). Hematological toxicity was minimal. Gastrointestinal toxicity was common. Response evaluation was possible for 26 patients. Three patients (9.7% intent-to-treat) achieved a partial response. Eight patients had stable disease, and 15 patients had progressive disease after two treatment courses. The median time to progression was 10 weeks (range, 5-51 weeks). Medial survival was 34 weeks (range, 7-112+).

Conclusion: Altretamine should not be chosen as standard treatment in patients with platinum-resistant recurrent ovarian cancer. However, Altretamine represents a useful alternative in patients who prefer oral treatment or when socioeconomic considerations are an important issue.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase II

MeSH terms

  • Administration, Oral
  • Aged
  • Altretamine / adverse effects
  • Altretamine / therapeutic use*
  • Antineoplastic Agents, Alkylating / adverse effects
  • Antineoplastic Agents, Alkylating / therapeutic use*
  • Drug Resistance, Neoplasm
  • Female
  • Humans
  • Middle Aged
  • Organoplatinum Compounds / therapeutic use
  • Ovarian Neoplasms / drug therapy*

Substances

  • Antineoplastic Agents, Alkylating
  • Organoplatinum Compounds
  • Altretamine