A randomized study of single agent vs combination chemotherapy in FIGO stages IIB, III and IV ovarian adenocarcinoma

Aabo, Kristian; Hald, Inge; Hørbov, Steen; Dombernowsky, P; Hansen, Heine H.; Sørensen, Hilda Mygind; Lundvall, Finn; Nielsen, Niels Chr.; Sørensen, Bent

doi:10.1016/0277-5379(85)90040-9

Cited by 18 publications

(2 citation statements)

References 11 publications

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“…Treosulfan (Ovastat ® , L-threitol-1,4-dimethasulfonate, (2S,3S)-1,4-dimesyloxy-2,3-butanediol, dihydroxybusulfan) is a water-soluble prodrug of a bifunctional alkylating agent approved for therapy of advanced ovarian carcinoma in Europe. 9, 10 This drug has several characteristics that make it attractive for use in HCT compared to busulfan. Treosulfan metabolism bypasses the liver, has a highly predictable pharmacokinetic (PK) profile in adults, is sufficiently immunosuppressive for engraftment of donor cells across histocompatibility barriers, and is highly anti-leukemic.…”

Section: Introductionmentioning

confidence: 99%

Treosulfan, Fludarabine, and Low-Dose Total Body Irradiation for Children and Young Adults with Acute Myeloid Leukemia or Myelodysplastic Syndrome Undergoing Allogeneic Hematopoietic Cell Transplantation: Prospective Phase II Trial of the Pediatric Blood and Marrow Transplant Consortium

Nemecek

Hilger²,

Adams

et al. 2018

Biology of Blood and Marrow Transplantation

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This multicenter study evaluated a treosulfan-based regimen in children and young adults with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) undergoing allogeneic hematopoietic cell transplant (HCT). Forty patients with median age 11 years (range, 1 to 19) underwent allogeneic HCT for AML in first (n = 18), second (n = 11), and third or greater remission (n = 3) or MDS (n = 8) using bone marrow (n = 25), peripheral blood stem cells (n = 5), or cord blood (n = 9). The regimen consisted of body surface area (BSA)-based treosulfan 10 g/m/day (BSA ≤ .5 m), 12 g/m/day (BSA > .5 to 1.0 m), or 14 g/m/day (BSA > 1.0 m) on days -6 to -4; fludarabine 30 mg/m/day on days -6 to -2; and a single fraction of 200 cGy total body irradiation on day -1. Graft-versus-host disease (GVHD) prophylaxis included tacrolimus and methotrexate for marrow and peripheral blood stem cell and cyclosporine/mycophenolate mofetil for cord blood. One-year overall survival, disease-free survival, and nonrelapse mortality were 80%, 73%, and 3%, respectively. One-year relapse was 38% for AML and 13% for MDS. No serious organ toxicities were observed. All 37 assessable patients engrafted. Cumulative incidences of grades II to IV acute GVHD and chronic GVHD were 22% and 40%, respectively. BSA-based treosulfan dosing resulted in predictable area under the curve and maximum concentration, which is required for dosing without measuring individual pharmacokinetic parameters. Observed differences in pharmacokinetics did not impact disease control or regimen toxicity. This BSA-based treosulfan regimen resulted in excellent engraftment and disease-free survival and minimal toxicity and transplant-related mortality (3%) in children and young adults with AML and MDS.

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Section: Introductionmentioning

confidence: 99%

Treosulfan, Fludarabine, and Low-Dose Total Body Irradiation for Children and Young Adults with Acute Myeloid Leukemia or Myelodysplastic Syndrome Undergoing Allogeneic Hematopoietic Cell Transplantation: Prospective Phase II Trial of the Pediatric Blood and Marrow Transplant Consortium

Nemecek

Hilger²,

Adams

et al. 2018

Biology of Blood and Marrow Transplantation

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“…The evaluation of the clinical response rates from the literature for the agents listed in Table 1 is provided in Table 2 and includes ranges encompassing the results of each study and the weighted averages of all results included in a given range (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36) . In evaluating the literature-reported clinical response rates, the majority of sources describe agent use in recurrent tumors, with only cyclophosphamide being more commonly reported in primary use.…”

Section: Resultsmentioning

confidence: 99%

Differential in vitro effects of chemotherapeutic agents on primary cultures of human ovarian carcinoma

Kornblith

Ochs

Wells

et al. 2004

Int J Gynecol Cancer

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The treatment of ovarian cancer principally relies on the use of platinum and taxane chemotherapeutic agents. Short-term clinical results have been encouraging, but long-term responses remain limited. In this report, an in vitro assay system that utilizes cells grown from human tumor explants has been used to quantitatively evaluate responses to relevant concentrations of alternative chemotherapeutic agents. The results suggest that there are significant differences in the responses of explant-derived cultured cells to the different agents tested. In an evaluation of 276 primary ovarian cancer specimens, five nonstandard drugs were tested in 51 cases. Of these 51 cases, cyclophosphamide had the highest rate of response at 67%, followed by doxorubicin at 61%, gemcitabine at 49%, etoposide at 48%, and topotecan at 14%. Venn diagrams, representing the in vitro responses to the platins and taxanes, as well as the responses to the nonstandard drugs, illustrate that there clearly are distinct differences among patients in a given population. These data underscore the potential importance of evaluating each patient's response to a number of different drugs to optimize the therapeutic decision-making process.

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Chemotherapy for advanced ovarian cancer

Stewart

1999

Cochrane Database of Systematic Reviews

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A randomized study of single agent vs combination chemotherapy in FIGO stages IIB, III and IV ovarian adenocarcinoma

Cited by 18 publications

References 11 publications

Treosulfan, Fludarabine, and Low-Dose Total Body Irradiation for Children and Young Adults with Acute Myeloid Leukemia or Myelodysplastic Syndrome Undergoing Allogeneic Hematopoietic Cell Transplantation: Prospective Phase II Trial of the Pediatric Blood and Marrow Transplant Consortium

Treosulfan, Fludarabine, and Low-Dose Total Body Irradiation for Children and Young Adults with Acute Myeloid Leukemia or Myelodysplastic Syndrome Undergoing Allogeneic Hematopoietic Cell Transplantation: Prospective Phase II Trial of the Pediatric Blood and Marrow Transplant Consortium

Differential in vitro effects of chemotherapeutic agents on primary cultures of human ovarian carcinoma

Chemotherapy for advanced ovarian cancer

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