Sequence dependence of hematologic toxicity using carboplatin and topotecan for primary therapy of advanced epithelial ovarian cancer: a phase I study of the Gynecologic Oncology Group

Gynecologic Oncology
Michael A BookmanPaula M Fracasso

Abstract

Selection of a feasible sequence and schedule of carboplatin in combination with topotecan for evaluation in advanced epithelial ovarian cancer (EOC). Women with stages III-IV EOC or primary peritoneal carcinoma without prior chemotherapy were assigned to consecutive cohorts evaluating a "forward" (carboplatin day 1, topotecan days 1-3), "reverse" (carboplatin day 3, topotecan days 1-3), or "extended reverse" sequence (carboplatin day 5, topotecan days 1-5). Patients received 4 cycles carboplatin-topotecan followed by 4 cycles carboplatin-paclitaxel. Feasibility was defined according to the cumulative proportion of patients with dose-limiting events (DLEs) during the first four cycles. Sixty-eight patients were enrolled across 5 cohorts. The forward sequence demonstrated unacceptable hematologic DLEs at the lowest topotecan dose (0.75 mg/m2/day x 3 days). The reverse sequence was feasible at 1.25 mg/m2/day x 3 days, with only 1/15 patients experiencing a DLE within 4 cycles, and 14/15 patients were able to receive 4 subsequent cycles of carboplatin-paclitaxel. The extended reverse sequence was associated with excessive DLEs at 1.00 mg/m2/day x 5 days. Prophylactic hematopoietic growth factors were not required. Higher doses of ...Continue Reading

References

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Citations

May 21, 2014·Journal of the National Cancer Institute·Michael A Bookman
Feb 20, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Michael A BookmanLawrence M Roth
Dec 18, 2008·Future Oncology·Dirk O BauerschlagJakobus Pfisterer
Apr 11, 2008·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·M A Bookman
Oct 9, 2007·Cancer Chemotherapy and Pharmacology·Dominique KoensgenUNKNOWN North-Eastern German Society of Gynecological Oncology Study Group-Ovarian Cancer

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