Data di Pubblicazione:
2001
Citazione:
Clinical Evidence for Topotecan-Paclitaxel Non–Cross-Resistance in Ovarian Cancer / M. Gore, W. ten Bokkel Huinink, J. Carmichael, A. Gordon, N. Davidson, R. Coleman, M. Spaczynski, J.F. Héron, G. Bolis, H. Malmström, J. Malfetano, C. Scarabelli, P. Vennin, G. Ross, S.Z. Fields. - In: JOURNAL OF CLINICAL ONCOLOGY. - ISSN 0732-183X. - 19:7(2001 Apr), pp. 1893-1900.
Abstract:
Purpose: A large, randomized study comparing the
efficacy and safety of topotecan versus paclitaxel in
patients with relapsed epithelial ovarian cancer
showed that these two compounds have similar activity.
In this study, a number of patients crossed over to
the alternative drug as third-line therapy, ie, from paclitaxel
to topotecan and vice versa. We therefore were
able to assess the degree of non–cross-resistance between
these two compounds.
Patients and Methods: Patients who had progressed
after one platinum-based regimen were randomized to
either topotecan (1.5 mg/m2/d) 3 5 every 21 days (n 5
112) or paclitaxel (175 mg/m2 over 3 hours) every 21
days (n 5 114). A total of 110 patients received crossover
therapy with the alternative drug (61 topotecan,
49 paclitaxel) as third-line therapy.
Results: Response rates to third-line cross-over therapy
were 13.1% (8 of 61 topotecan) and 10.2% (5 of 49
paclitaxel; P 5 .638). Seven patients who responded to
third-line topotecan and four patients who responded
to paclitaxel had failed to respond to their second-line
treatment. Median time to progression (from the start of
third-line therapy) was 9 weeks in both groups, and
median survival was 40 and 48 weeks for patients who
were receiving topotecan or paclitaxel, respectively.
The principal toxicity was myelosuppression; grade 4
neutropenia was more frequent with topotecan (81.4%
of patients) than with paclitaxel (22.9% of patients).
Conclusion: Topotecan and paclitaxel have similar
activity as second-line therapies with regard to response
rates and progression-free and overall survival.
We demonstrated that the two drugs have a degree of
non–cross-resistance. Thus, there is a good rationale for
incorporating these drugs into future first-line regimens.
Tipologia IRIS:
01 - Articolo su periodico
Elenco autori:
M. Gore, W. ten Bokkel Huinink, J. Carmichael, A. Gordon, N. Davidson, R. Coleman, M. Spaczynski, J.F. Héron, G. Bolis, H. Malmström, J. Malfetano, C. Scarabelli, P. Vennin, G. Ross, S.Z. Fields
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