Duration of response to second-line, platinum-based chemotherapy for ovarian cancer: Implications for patient management and clinical trial design
Duration of response to second-line, platinum-based chemotherapy for ovarian cancer: Implications for patient management and clinical trial design
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DOI：
10.1200/jco.2004.05.195
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发表时间：
2004-08-01
影响因子：
45.3
通讯作者：
Belinson, J
中科院分区：
文献类型：
--
作者：
Markman, M;Markman, J;Belinson, J
PurposeLimited的信息是关于影响的持续时间先前的反应对铂化疗在复发性ovarian cancer.Patients和MethodsWe回顾性审查了1993年至2003年4月接受两个或两个以上的铂为基础的方案复发的恶性肿瘤在克利夫兰诊所治疗卵巢癌的妇女的医疗记录。如果患者满足特定标准，包括对可测量或可评估疾病的有利影响，则认为他们对二线治疗有反应。结果在此期间，共对176名复发性卵巢癌女性进行了211种铂类药物治疗方案，在125次治疗中观察到反应（59%）。在121例目前可评估的次要缓解中，只有4例（3%）的持续时间长于特定个体的既往缓解。在这四种情况下，在二线的方法中使用的铂为基础的方案包括一种药物，没有被用于在该患者的主要化疗program.ConclusionThe长度的先前响应铂为基础的治疗卵巢癌是高度预测的上限响应的持续时间，以随后的铂程序，假设使用相同或相似的药物。该临床参数的知识可能有助于为个体患者制定最佳管理，并可能在临床试验设计中被利用，以检查对铂类方案实现继发性应答的女性中使用细胞毒性和细胞生长抑制剂的新型维持策略。(C)2004年，美国临床肿瘤学会。
PurposeLimited information is available regarding the influence of the duration of a prior response on the length of a subsequent response to platinum chemotherapy in recurrent ovarian cancer.Patients and MethodsWe retrospectively reviewed the medical records of women with ovarian cancer treated at the Cleveland Clinic from 1993 through April 2003 who received two or more platinum-based regimens for recurrence of the malignancy. Patients were considered to have responded to second-line therapy if they satisfied specific criteria, including favorable effects on both measurable or assessable disease.ResultsA total of 211 platinum-based regimens were administered to 176 women with recurrent ovarian cancer during this time period, with a response being observed in 125 treatment episodes (59%). Only four (3%) of 121 currently assessable secondary responses were of longer duration than the prior response in a specific individual. In three of these four cases, the platinum-based regimen used in the second-line approach included a drug that had not been used in that patient's primary chemotherapy program.ConclusionThe length of a prior response to platinum-based therapy in ovarian cancer is highly predictive of the upper limit of the duration of response to a subsequent platinum program, assuming the same or similar drugs are used. Knowledge of this clinical parameter may assist in developing optimal management for an individual patient and may potentially be exploited in clinical trial designs examining novel maintenance strategies with both cytotoxic and cytostatic agents in women who achieve a secondary response to a platinum-based regimen. (C) 2004 by American Society of Clinical Oncology.