(ChemotherapyAdvisor) – Dose-dense weekly paclitaxel/carboplatin can safely substitute for paclitaxel/cisplatin to reduce induction therapy–associated toxicity among patients diagnosed with progressive platinum-resistant epithelial ovarian cancer (EOC), report authors of a long-term analysis published in the European Journal of Cancer.
“Six cycles weekly paclitaxel/carboplatin followed by six 3-weekly cycles is well-tolerated and highly active in platinum-resistant and platinum-sensitive patients,” reported M.E.L. van der Burg and colleagues at Erasmus MC Rotterdam in Rotterdam, the Netherlands and the University Hospital Leuven, in Belgium.
After 3-weekly paclitaxel/carboplatin, patients with EOC were treated with six cycles weekly paclitaxel (90 mg/m2) and carboplatin AUC (area under the curve) 4 mg/mL/min, followed by six cycles 3-weekly paclitaxel/carboplatin, the authors reported.
“Median progression free survival (PFS) after last platinum was 9 months (range, 0-81 months) in 108 patients; 43 were platinum-resistant, of whom 13 started weekly paclitaxel/carboplatin less than 6 months after progression,” the authors reported. “During 533 weekly cycles, grade 3/4 toxicity included: thrombocytopenia 8%, neutropenia 30%, febrile neutropenia 0.5%. Nonhematologic toxicity was low. Treatment was delayed in 16% and dose reduced in 2% of cycles.”
Median PFS was 8 months (range, 1-21 months) and 13 months (range, 1-46 months) for platinum-resistant and platinum-sensitive patients, respectively. Median overall survival (OS) was 15 (range, 1-69) and 26 (range, 4-93) months, respectively.
“The 13 platinum-resistant patients with a platinum-therapy free interval less than 6 months had a significantly shorter PFS (4 vs. 10 months; P=0.035) and OS (9 vs. 15 months, P=0.002),” the authors noted. “The platinum therapy-free interval seemed to be a good criterion to select poor-risk, platinum-resistant patients.”