Ovarian Cancer Research Today is a free monthly online journal that collates and summarizes the latest research about Ovarian Cancer, including details on symptoms, causes, treatment, information.

Phase II study of weekly topotecan in patients with recurrent or persistent epithelial ovarian cancer.

Levy T, Inbar M, Menczer J, Grisaru D, Glezerman M, Safra T

Division of Gynecologic Oncology, Wolfson Medical Center, Holon, the Sackler Faculty of Medicine, Tel Aviv, Israel. levtalia@netvision.net.il

OBJECTIVE: To assess the toxicity and effectiveness of once-weekly administration of topotecan (Hycamtin; GlaxoSmithKline) for relapsed ovarian and primary peritoneal cancer. METHODS: Twenty-three patients with recurrent or persistent epithelial ovarian cancer (EOC) and primary peritoneal carcinoma (PPC) previously exposed to at least one line of platinum-based chemotherapy were treated with IV weekly topotecan as a 30-min bolus at a starting dose of 4 mg/m(2) administered weekly for 3 weeks in a 28-day cycle. RESULTS: The patients' median age was 62 years (42-83). Thirteen women (56.5%) were defined as having platinum-sensitive and 10 (43.5%) as having platinum-resistant disease. Altogether, 88 cycles were administered for a total of 264 weekly treatments, with a median of four courses (range 2-6). There were no treatment delays. The main bone marrow toxicity was grade II and III thrombocytopenia, necessitating dose reduction in four patients (17.4%) and treatment cessation in one patient. The most frequent nonhematologic toxicity was fatigue (nine patients, 39.1%). There were four complete responses (17.4%, three in the platinum-sensitive and one in the platinum-resistant patients) and seven (30.4%) partial responses, for an overall response rate of 47.8%. The ORR was similar in platinum-sensitive and platinum-resistant patients (47.8% and 52.2%, respectively). The median progression-free survival was 4.9 months with a mean survival time of 11.59 months. Two women sustained complete response lasting >6 months. CONCLUSION: Topotecan given as a weekly bolus is a highly active and well-tolerated treatment regimen for relapsed ovarian and primary peritoneal cancer and thus deserves further evaluation.

Published 7 December 2004 in Gynecol Oncol, 95(3): 686-90.
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