Second-line therapy with paclitaxel and carboplatin for recurrent disease following first-line therapy with paclitaxel and platinum in ovarian or peritoneal carcinoma
Second-line therapy with paclitaxel and carboplatin for recurrent disease following first-line therapy with paclitaxel and platinum in ovarian or peritoneal carcinoma
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DOI：
10.1200/jco.1998.16.4.1494
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发表时间：
1998-04-01
影响因子：
45.3
通讯作者：
Rodriguez, M
中科院分区：
文献类型：
--
作者：
Rose, PG;Fusco, N;Rodriguez, M
目的：紫杉醇联合铂类化合物是治疗晚期卵巢癌最有效的一线方案。目前的研究是为了评估这种组合在卵巢癌或腹膜癌患者的再治疗中的作用，这些患者在这种组合后疾病复发大于或等于6个月。研究了25例复发性卵巢癌或腹膜癌患者，这些患者在一线紫杉醇和铂类化疗完全临床应答后≥ 6个月，通过计算机断层扫描（CT）、CA 125水平升高或手术结果记录疾病复发。二线化疗包括紫杉醇135 mg/m2 24小时输注和卡铂，浓度-时间曲线下面积（AUC）为5 - 6，每21天一次，对治疗的反应被归类为可测量或assessable.Results：一线治疗后复发的中位时间为10个月（范围，6至30）。在20例可测量和可评估的患者中，14例（70%）显示完全临床应答，4例（20%）显示部分临床应答，可测量疾病的应答率为91%，可评估疾病的应答率为89%，所有患者的中位无进展间隔为9.0+个月（范围，2 - 15），患有可测量或可评估疾病的患者的中位无进展间期为9.0+个月，不可评估疾病的患者为7.0+个月。15例患者（60%）在二次治疗后复发，中位间隔为9.0个月（范围，2至15），仅2例患者在二次治疗后死亡，中位生存期为10.0+个月（范围，2.0至21.0+）。结论：在该敏感人群中使用该联合治疗具有高缓解率和长无进展间隔。在化疗敏感人群中，必须从这个角度解释替代二线药物的活性。(C)1998年，美国临床肿瘤学会。
Purpose: The combination of paclitaxel and a platinum compound is the most active first-line regimen for advanced ovarian carcinoma. The current study was undertaken to evaluate this combination in the retreatment of patients with ovarian or peritoneal carcinoma who had disease recurrence greater than or equal to 6 months following this combination.Methods: Twenty-five patients with recurrent ovarian or peritoneal carcinoma greater than or equal to 6 months after a complete clinical response with first-line paclitaxel and platinum chemotherapy were studied, Recurrent disease was documented by computed tomography (CT), elevated CA 125 level, or surgical findings, Second-line chemotherapy consisted of paclitaxel 135 mg/m(2) as a 24 hour infusion and carboplatin at an area under the concentration-time curve (AUG) of 5 to 6 every 21 days, Response to therapy was classified as measurable or assessable.Results: The median time to recurrence after first-line therapy was 10 months (range, 6 to 30). Among 20 measurable and assessable patients, 14 (70%) demonstrated a complete clinical response and four (20%) a partial clinical response, The response rate with measurable disease was 91% and with assessable disease was 89%, The median progression-free interval for all patients was 9.0+ months (range, 2 to 15), The median progression-free interval for patients with measurable or assessable disease was 9.0+ months and for nonassessable disease was 7.0+ months. Fifteen patients (60%) have developed recurrence after secondary therapy at a median interval of 9.0 months (range, 2 to 15), Only two patients have died with a median survival after secondary therapy of 10.0+ months (range, 2.0 to 21.0+),Conclusion: The use of this combination, in this sensitive population, has a high response rate and long progression-free interval. In a chemotherapy-sensitive population, the activity of alternative second-line agents must be interpreted with this perspective. (C) 1998 by American Society of Clinical Oncology.