Prophylactic granulocyte colony-stimulating factor allows escalation of chemotherapeutic dose intensity in advanced epithelial ovarian cancer

Gynecologic Oncology
J Fanning, R D Hilgers

Abstract

In an effort to discover an effective regimen for use in Phase III evaluation of the efficacy of dose intensification in advanced ovarian cancer, we performed a Phase II trial of dose intensified cisplatin, etoposide, and ifosfamide with granulocyte colony-stimulating factor (G-CSF). Thirty patients with primary, FiGO Stage 3 or 4, epithelial ovarian cancer underwent intensified cytoreduction followed by cisplatin 105 mg/m2, etoposide 300 mg/m2 and ifosfamide/mesna 3 g/m2, q 28 days x 6 cycles with G-CSF 5 microg/kg q day for 7 days. The dose of etoposide and ifosfamide was escalated 20% in cohorts of three patients. Intensified cytoreductive surgery was successful in resecting all gross tumor in 24 patients (80%). At the original dose of cisplatin, etoposide, and ifosfamide without G-CSF, 55% of cycles resulted in neutropenia and 38% in thrombocytopenia (dose intensity = 0.8). With the addition of G-CSF, neutropenia developed in 5% of cycles and thrombocytopenia in 38%. At a 20% escalation of etoposide and ifosfamide, neutropenia developed in 17% of cycles and thrombocytopenia in 50% (dose intensity = 1.2). At a 40% escalation of etoposide and ifosfamide, neutropenia developed in 33% of cycles and thrombocytopenia in 83%, whic...Continue Reading

Citations

Jul 2, 2016·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Insiya B PoonawallaXianglin L Du
Oct 29, 2015·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Insiya B PoonawallaXianglin L Du

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