Rational Use of Cytotoxic Chemotherapy for Recurrent Ovarian Cancer

Authors:
Joyce Liu From the Department of Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.

Search for other papers by Joyce Liu in
Current site
Google Scholar
PubMed
Close
 MD
and
Ursula Matulonis From the Department of Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.

Search for other papers by Ursula Matulonis in
Current site
Google Scholar
PubMed
Close
 MD
Full access

Ovarian cancer remains the leading cause of death among women with gynecologic malignancies, and the fifth leading cause of cancer mortality in women in the United States. Although many patients respond to first-line platinum-based therapy, most will experience disease recurrence. The role of further therapy in the setting of recurrent ovarian cancer is palliative, and large randomized phase III trials on treatment options for recurrent ovarian cancer are rare. Controversies exist as to the optimal timing and duration of treatment, and many issues regarding treatment of recurrent disease remain.

Correspondence: Ursula Matulonis, MD, Department of Oncology, Dana-Farber Cancer Institute, Dana Building, 44 Binney Street, Boston, MA 02115. E-mail: ursula_matulonis@dfci.harvard.edu
  • Collapse
  • Expand
  • 1.

    Jemal A, Siegel R, Ward E et al.. Cancer statistics, 2006. CA Cancer J Clin 2006;56:106130.

  • 2.

    McGuire WP, Hoskins WJ, Brady MF et al.. Cyclophosphamide and cisplatin compared with paclitaxel and cisplatin in patients with stage III and stage IV ovarian cancer. N Engl J Med 1996;334:16.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Ozols RF, Bundy BN, Greer BE et al.. Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: a Gynecologic Oncology Group study. J Clin Oncol 2003;21:31943200.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Cannistra SA. Cancer of the ovary. N Engl J Med 2004;351:25192529.

  • 5.

    Herzog TJ. Recurrent ovarian cancer: how important is it to treat to disease progression? Clin Can Res 2004;10:74397449.

  • 6.

    Cesano A, Lane SR, Poulin R et al.. Stabilization of disease as a useful predictor of survival following second-line chemotherapy in small cell lung cancer and ovarian patients. Int J Oncol 1999;15:12331238.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Medical Research Council. OV05: A randomized trial in relapsed ovarian cancer: early treatment based on CA 125 levels alone versus delayed treatment based on conventional clinical indicators. 2003. Available at http://www.ctu.mrc.ac.uk/studies/documents/OV05v21.pdf#search=%22OV05%20studies%22. Last accessed August 31, 2006.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Markman M, Rothman R, Hakes T et al.. Second-line platinum therapy in patients with ovarian cancer previously treated with cisplatin. J Clin Oncol 1991;9:389393.

  • 9.

    Markman M, Markman J, Webster K et al.. Duration of response to second-line, platinum-based chemotherapy for ovarian cancer: implications for patient management and clinical trial design. J Clin Oncol 2004;22:31203125.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Gore ME, Fryatt I, Wiltshaw E et al.. Treatment of relapsed carcinoma of the ovary with cisplatin or carboplatin following initial treatment with these compounds. Gynecol Oncol 1990;36:207211.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Bolis G, Scarfone G, Giardina G et al.. Carboplatin alone vs carboplatin plus epidoxorubicin as second-line therapy for cisplatinor carboplatin-sensitive ovarian cancer. Gynecol Oncol 2001;81:39.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Kavanagh J, Tresukosal D, Edwards C et al.. Carboplatin reinduction after taxane in patients with platinum-refractory epithelial ovarian cancer. J Clin Oncol 1995;13:15841588.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    ten Bokkel, Huinink W, Gore M, Carmichael J et al.. Topotecan versus paclitaxel for the treatment of recurrent epithelial ovarian cancer. J Clin Oncol 1997;15:21832193.

  • 14.

    Gordon AN, Fleagle JT, Guthrie D et al.. Recurrent epithelial ovarian carcinoma: a randomized phase III study of pegylated liposomal doxorubicin versus topotecan. J Clin Oncol 2001;19:33123322.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Cantu MG, Buda A, Parma G et al.. Randomized controlled trial of single-agent paclitaxel versus cyclophosphamide, doxorubicin, and cisplatin in patients with recurrent ovarian cancer who responded to first-line platinum-based regimens. J Clin Oncol 2002;20:12321237.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Armstrong DK. Relapsed ovarian cancer: challenges and management strategies for a chronic disease. Oncologist 2002;7(suppl 5):2028.

  • 17.

    Rose PG, Blessing JA, Mayer AR et al.. Prolonged oral etoposide as second-line therapy for platinum-resistant and platinum-sensitive ovarian carcinoma: a Gynecologic Oncology Group study. J Clin Oncol 1998;16:405410.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Campos SM, Penson RT, Mays AR et al.. The clinical utility of liposomal doxorubicin in recurrent ovarian cancer. Gynecol Oncol 2001;81:206212.

  • 19.

    Creemers J, Bolis G, Gore ME et al.. Topotecan, an active drug in the second-line treatment of epithelial ovarian cancer: results of a large European phase II study. J Clin Oncol 1996;14:30563061.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    McGuire WP, Rowinsky EK, Rosenshein NB et al.. Taxol: a unique antineoplastic agent with significant activity in advanced ovarian epithelial neoplasms. Ann Intern Med 1989;111:273279.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Gordon AN, Tonda M, Sun S et al.. Long-term survival advantage for women treated with pegylated liposomal doxorubicin compared with topotecan in a phase 3 randomized study of recurrent and refractory epithelial ovarian cancer. Gynecol Oncol 2004;95:18.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Rose PG, Fusco N, Fluellen L et al.. Second-line therapy with paclitaxel and carboplatin for recurrent disease following first-line therapy with paclitaxel and platinum in ovarian or peritoneal carcinoma. J Clin Oncol 1998;16:14941497.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Gronlund B, Hogdall C, Hansen H, Engelholm SA. Results of reinduction therapy with paclitaxel and carboplatin in recurrent epithelial ovarian cancer. Gynecol Oncol 2001;83:128134.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Parmar MK, Ledermann JA, Colombo N et al.. Paclitaxel plus platinum-based chemotherapy versus conventional platinum-based chemotherapy in women with relapsed ovarian cancer: the ICON4/AGO-OVAR-2.2 trial. Lancet 2003;361:20992106.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Gonzalez-Martin AJ, Calvo E, Bover I et al.. Randomized phase II trial of carboplatin versus paclitaxel and carboplatin in platinum-sensitive recurrent advanced ovarian carcinoma: a GEICO (Grupo Espanol de Investigacion en Cancer de Ovario) study. Ann Oncol 2005;16:749755.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Pfisterer J, Vergote I, Du Bois A et al.. Combination therapy with gemcitabine and carboplatin in recurrent ovarian cancer. Int J Gynecol Cancer 2005;15(suppl 1):3641.

  • 27.

    Lee CW, Matulonis UA, Castells MC. Carboplatin hypersensitivity: a 6-h 12-step protocol effective in 35 desensitizations in patients with gynecological malignancies and mast cell/IgE-mediated reactions. Gynecol Oncol 2004;95:370376.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Lee CW, Matulonis UA, Castells MC. Rapid inpatient/outpatient desensitization for chemotherapy hypersensitivity: standard protocol effective in 57 patients for 255 courses. Gynecol Oncol 2005;99:393399.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Einzig AI, Wiernik PH, Sasloff J et al.. Phase II study and long-term follow-up of patients treated with Taxol for advanced ovarian adenocarcinoma. J Clin Oncol 1992;10:17481753.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Markman M, Hall J, Spitz D et al.. Phase II trial of weekly single-agent paclitaxel in platinum/paclitaxel-refractory ovarian cancer. J Clin Oncol 2002;20:23652369.

  • 31.

    Markman M, Zanotti K, Webster K et al.. Phase 2 trial of single agent docetaxel in platinum and paclitaxel-refractory ovarian cancer, fallopian tube cancer, and primary carcinoma of the peritoneum. Gynecol Oncol 2003;91:573576.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Rose PG, Blessing JA, Ball HG et al.. A phase II study of docetaxel in paclitaxel-resistant ovarian and peritoneal carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 2003;88:130135.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Muggia FM, Hainsworth JD, Jeffers S et al.. Phase II study of liposomal doxorubicin in refractory ovarian cancer: antitumor activity and toxicity modification by liposomal encapsulation. J Clin Oncol 1997;15:987993.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Gordon AN, Granai CO, Rose PG et al.. Phase II study of liposomal doxorubicin in platinum- and paclitaxel-refractory epithelial ovarian cancer. J Clin Oncol 2000;18:30933100.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Markman M, Kennedy A, Webster K et al.. Phase 2 trial of liposomal doxorubicin (40 mg/m2) in platinum/paclitaxel-refractory ovarian and fallopian tube cancer and primary carcinoma of the peritoneum. Gynecol Oncol 2000;78:369372.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Kudelka AP, Tresukosol D, Edwards CL et al.. Phase II study of intravenous topotecan as a 5-day infusion for refractory epithelial ovarian carcinoma. J Clin Oncol 1996;14:15521557.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    de Wit R, van der Burg ME, van den Gaast A et al.. Phase II study of prolonged oral etoposide in patients with ovarian cancer refractory to or relapsing within 12 months after platinum-containing chemotherapy. Ann Oncol 1994;5:656657.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    D'Agostino G, Amant F, Berteloot P et al.. Phase II study of gemcitabine in recurrent platinum- and paclitaxel-resistant ovarian cancer. Gynecol Oncol 2003;88:266269.

  • 39.

    Markman M, Webster K, Zanotti K et al.. Phase 2 trial of single-agent gemcitabine in platinum-paclitaxel refractory ovarian cancer. Gynecol Oncol 2003;90:593596.

  • 40.

    Bajetta E, Di Leo A, Biganzoli L et al.. Phase II study with vinorelbine in patient with pretreated advanced ovarian cancer: activity in platinum-resistant disease. J Clin Oncol 1996;14:25462551.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Sorenson P, Moyer M, Jakobsen A et al.. Phase II study of vinorelbine in the treatment of platinum-resistant ovarian carcinoma. Gynecol Oncol 2001;81:5862.

  • 42.

    Markman M, Hakes T, Reichman B et al.. Ifosfamide and mesna in previously-treated advanced epithelial ovarian cancer: activity in platinum-resistant disease. J Clin Oncol 1992;10:243248.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43.

    Markman M, Kennedy A, Sutton G et al.. Phase 2 trial of ifosfamide/mesna in patients with platinum/paclitaxel refractory ovarian cancer who have not previously been treated with an alkylating agent. Gynecol Oncol 1998;70:272274.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Perez-Gracia JL, Carrasco EM. Tamoxifen therapy for ovarian cancer in the adjuvant and advanced settings: systematic review of the literature and implications for future research. Gynecol Oncol 2002;84:201209.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    del Carmen MG, Fuller AF, Matulonis UA et al.. Phase II trial of anastrozole in women with asymptomatic mullerian cancer. Gynecol Oncol 2003;91:596602.

  • 46.

    Thigpen JT, Blessing JA, Ball H et al.. Phase II trial of paclitaxel in patients with progressive ovarian carcinoma after platinum-based chemotherapy: a Gynecologic Oncology Group study. J Clin Oncol 1994;12:17481753.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47.

    Kita T, Kikuchi Y, Takano M et al.. The effect of single weekly paclitaxel in heavily pretreated patients with recurrent or persistent advanced ovarian cancer. Gynecol Oncol 2004;92:813818.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 48.

    Eisenhauer EA, ten Bokkel Huinink WW, Swenerton KD et al.. European-Canadian randomized trial of paclitaxel in relapsed ovarian cancer: high-dose versus low-dose and long versus short infusion. J Clin Oncol 1994;12:26542666.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 49.

    Israel VP, Garcia AA, Roman L et al.. Phase II study of liposomal doxorubicin in advanced gynecologic cancers. Gynecol Oncol 2000;78:143147.

  • 50.

    Rose PG, Maxson JH, Fusco N et al.. Liposomal doxorubicin in ovarian, peritoneal, and tubal carcinoma: a retrospective comparative study of single-agent dosages. Gynecol Oncol 2001;82:323328.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 51.

    O'Byrne KJ, Bliss P, Graham JD et al.. A phase III study of Doxil/Caelyx versus paclitaxel in platinum-treated, taxane-naive relapsed ovarian cancer [abstract]. Proc Am Soc Clin Oncol 2002;21. Abstract 808.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 52.

    Hoskins P, Eisenhauer E, Beare S et al.. Randomized phase II study of two schedules of topotecan in previously treated patients with ovarian cancer: a National Cancer Institute of Canada Clinical Trials Group study. J Clin Oncol 1998;16:22332237.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 53.

    Rodriguez M, Rose PG. Improved therapeutic index of lower dose topotecan chemotherapy in recurrent ovarian cancer. Gynecol Oncol 2001;83:257262.

  • 54.

    O'Malley DM, Azodi M, Makkenchery A et al.. Weekly topotecan in heavily pretreated patients with recurrent epithelial ovarian cancer. Gynecol Oncol 2005;98:242248.

  • 55.

    Monk BJ, Han E, Josephs-Cowan CA et al.. Salvage bevacizumab (rhuMAB VEGF)-based therapy after multiple prior cytotoxic regimens in advanced refractory epithelial ovarian cancer. Gynecol Oncol 2006;102:140144.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 56.

    Cannistra SA, Matulonis UA, Penson RT et al.. Bevacizumab in patients with advanced platinum-resistant ovarian cancer [abstract]. J Clin Oncol 2006;24(suppl). Abstract 5006.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 57.

    Markman M, Hakes T, Reichman B et al.. Intraperitoneal cisplatin and cytarabine in the treatment of refractory or recurrent ovarian carcinoma. J Clin Oncol 1991;9:204210.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 58.

    Morgan RJ Jr, Alvarez RD, Armstrong DK et al.. The NCCN Ovarian Cancer Guidelines, version 1. 2006. Available at: http://www.nccn.org/professionals/physician_gls/PDF/ovarian.pdf. Accessed July 25, 2006.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 59.

    Swisher EM, Mutch DG, Rader JS et al.. Topotecan in platinum and paclitaxel-resistant ovarian cancer. Gynecol Oncol 1997;66:480486.

  • 60.

    Markman M, Blessing JA, Moore DH et al.. Altretamine (hexamethylmelamine) in platinum-resistant and platinum-refractory ovarian cancer: a Gynecologic Oncology Group phase II trial. Gynecol Oncol 1998;69:226229.

    • PubMed
    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 1371 587 182
PDF Downloads 254 42 7
EPUB Downloads 0 0 0