As first line Chemotherapy in ovarian cancer: Topotecan in combination with Platinum chemotherapy does not give any added value in effectiveness and even more and graver side effects seen from phase II study in multiple hospitals.

1 november 2005: source; Gynecol Oncol. 2005 Oct. 24;

The chemo combination gives no added value in effectiveness with topotecan cisplatin and taxol and Platinum even more side effects than chemotherapy (cisplatin, carboplatin, etc.) as first line treatment at eeirstokkanker. What even though no success in ovarian cancer, see other studies under chemo in ovarian cancer. This is evidenced by new large phase II study carried out in multiple hospitals. The conclusions of the researchers: more investigation into the topotecan and cisplatin and carboplatin taxol and combinations. What a waste of money and energy and you'll but the patient are involved in such a trial. You are as patient purely a Guinea pig with the knowledge that even that nothing will bring for the future. With all due respect for scientific research but this is my eyes almost criminal to spite all the negative results yet but again a new study.

Prolonged topotecan infusion with cisplatin in the first-line treatment of ovarian cancer: An NYGOG and ECOG study.

Hochster HS, Plimack Mandeli, J, S, C, Goldberg G Wadler Runowicz, Speyer J, Wallach R, Muggia F; for the New York Gynecologic Oncology Group (and phase II consortium) and the Eastern Cooperative Oncology.
NYU School of Medicine and Cancer Institute, 160 East 34th Street, New York, NY 10016, USA.

OBJECTIVE: To determine the toxicity and efficacy of combined therapy with cisplatin and topotecan prolonged infusion therapy in women with axis front line epithelial ovarian cancer.

PATIENTS AND METHODS.: Women with untreated, measurable and non-measurable previously epithelial ovarian cancer, internships Ic IV were eligible. Patients were treated with cisplatin 75 mg/m (2) on day 1, followed by topotecan 0.3 to 0.4 mg/m (2)/day given as a continuous infusion on 14-21 days, every 28 days. Dose levels and duration of infusion were adjusted for toxicity as appropriate. Patients were evaluated for response to treatment and treatment toxicity by standard NYGOG criteria.

RESULTS: Sixty patients were enrolled. Among the 20 patients with post-surgical residual disease > 2 cm, 80% [95% CI (56.3%, 94.3%)] demonstrated an objective response to therapy. The median progression-free survival for all 60 patients enrolled was 19.3 months with a median overall survival of 45.6 months given the median follow-up or 55 months (range 6-81 months). Five year survival is estimated to be 41%. Toxicity was observed in the first four patients treated with topotecan (0.4 mg/m (2)/day x 21 days) and was continued at 0.3 mg/m dosing (2)/day x 14 days thereafter. Of the 56 patients treated at the amended dose level, marrow suppression continued to be dose-limiting, with 86% of patients experiencing grade 3 or 4 neutropenia, thrombocytopenia and 55% experiencing grade 3 or 4 50% of patients experiencing grade 3 or 4 anemia.Nonetheless, only 11 were associated with febrile neutropenia/245 cycles administered and/or infection (8 port-related). Other non-hematologic toxicity was as expected. There were no treatment-related deaths.

CONCLUSION: This large, multicenter phase II study of prolonged infusion topotecan in combination with cisplatin demonstrated similar response, time to progression and survival compared with reported results of taxane and platinum combinations. Hematologic toxicity was greater but tolerated. Further studies investigating topotecan in combination with platinum therapy as a first line agent are warranted.
>, br PMID: 16253316 [PubMed-as supplied by publisher]