Advanced Ovarian Adenocarcinoma A Prospective Clinical Trial of Melphalan (L-PAM) Versus Combination Chemotherapy

Young, Robert C.; Chabner, Bruce A.; Hubbard, Susan M.; Fisher, Richard I.; Bender, Richard A.; Anderson, Tom; Simon, Richard; Canellos, George P.; DeVita, Vincent T.

doi:10.1097/00006254-197905000-00027

Cited by 41 publications

(47 citation statements)

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“…A striking relationship was found between the number of cycles of chemotherapy given prior to second look surgery, and the incidence of residual disease found at surgery (14.6% negative second look after 2-9 courses of melphalan; 43.7% for > 10 courses of melphalan). (Young et al, 1978;Oldham et al, 1982;Raju et al, 1982 A relatively common result of these procedures, not alluded to in the literature was that the findings were equivocal at surgery; many patients with initial gross tumour were found to have dense abdominal and/or pelvic adhesions with poor planes of cleavage and surgery proved technically difficult. Despite negative biopsies, relapse occurred in 4 of 5 such patients and close follow up is clearly mandatory.…”

Section: Resultsmentioning

confidence: 99%

“…In addition an attempt is made to debulk as effectively as possible residual metastatic disease (Griffiths 1975;Griffiths et al, 1979). Following surgery chemotherapy is administered either as a single agent, or more recently as a drug combination (Young et al, 1978;Katz et al, 1981;Williams et al, 1982). Evaluation of tumour response during this therapy is often difficult, and it is widely recognised that neither clinical examination nor the radiological procedures currently available are satisfactory to assess the effectiveness of treatment.…”

mentioning

confidence: 99%

“…More recently, and with the advent of combination chemotherapy, second look surgery (laparoscopy or laparotomy) has been used earlier in the clinical course, to date the time of complete remission and thereby decide the number of cycles of chemotherapy that need to be given (Young et al, 1978;Ozols et al, 1981;Oldham et al, 1982;Raju et al, 1982). There is, however, no evidence to suggest that survival can be increased by use of these techniques, and in addition only scanty evidence exists that combination chemotherapy produces survival that is superior to single agents (Young et al, 1978;Katz et al, 1981;Pereira et al, 1981;Sturgeon et al, 1982;Carmo-Pereira et al, 1982;Vogl et al, 1982;Omura et al, 1983).…”

mentioning

confidence: 99%

“…There is, however, no evidence to suggest that survival can be increased by use of these techniques, and in addition only scanty evidence exists that combination chemotherapy produces survival that is superior to single agents (Young et al, 1978;Katz et al, 1981;Pereira et al, 1981;Sturgeon et al, 1982;Carmo-Pereira et al, 1982;Vogl et al, 1982;Omura et al, 1983). We have analysed our own experience of second look laparotomy in an attempt to evaluate its influence on our management of this relatively common disorder.…”

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confidence: 99%

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Second look laparotomy in the management of epithelial cell carcinoma of the ovary

Mead¹,

Williams²,

Macbeth³

et al. 1984

Br J Cancer

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Summary Case histories from 20 patients undergoing postchemotherapy "second look" laparotomy for metastatic epithelial cell carcinoma of the ovary were reviewed in an attempt to evaluate the usefulness of this procedure and its likely impact on patient survival. The patient population comprised 18 patients treated with a combination of cisplatin, adriamycin and cyclophosphamide (PACe) and 2 patients treated with chlorambucil. The findings at second look were often predictable, and related to the adequacy of initial surgery. Complete tumour regression identified a group of patients with a relatively good prognosis. However in most patients residual tumour was found which rarely proved resectable. Second line chemotherapy was poorly tolerated, and appeared to have little impact on the disease particulary after combination chemotherapy had been used initially.There was little evidence that second look surgery itself positively contributed to survival. This procedure and its timing should be regarded as experimental and a suitable subject for randomised clinical trials.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

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Second look laparotomy in the management of epithelial cell carcinoma of the ovary

Mead¹,

Williams²,

Macbeth³

et al. 1984

Br J Cancer

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“…Data from early clinical studies using melphalan as secondline chemotherapy of stage III-IV ovarian carcinoma have been encouraging (25)(26)(27)(28)(29)(30)(31)(32). In light of these results, a phase II study of melphalan as a single-agent infused over a 24-h period was initiated.…”

Section: Discussionmentioning

confidence: 99%

Phase II study of melphalan as a single-agent infused over a 24-hour period with individual adapted dosing in patients with recurrent epithelial ovarian cancer

Mougenot

Fabbro²,

Bressolle³

et al. 2006

Oncol Rep

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Abstract. The current study was performed to evaluate the efficacy and toxicity of a chemotherapy treatment using melphalan administered over a 24-h period with individual adapted dosing in advanced ovarian cancer. Melphalan was infused intravenously with an automatic infusion pump over a 24-h period. The schedule was repeated every 28 days for a maximum of 6 cycles. The initial administered dose was 25 mg/m 2 . Drug adjustment was then made using a population approach, with the aim of constraining the overall area under the plasma concentration-time curve within 2.0-2.5 mg • h/l. A total of 96 courses of chemotherapy was administered. The toxicity profile did not differ greatly from that reported after a 1-h infusion and was acceptable in such a heavily pretreated patient population. Twenty-five patients were assessable for response and survival. Four (16%) partial responses were observed, which lasted 9, 10, 13 and 37 months, respectively. Three patients experienced stable disease during 8, 14 and 22 months, respectively. The 1-and 2-year survival rates were 18% and 6%, respectively. At the time of analysis, two patients remained alive with progressive disease at 22 and 37 months, respectively. In conclusion, melphalan administered over a 24-h period in platinum-and taxane-resistant ovarian cancer patients appeared to provide some clinical benefits with manageable toxicity. Based on these results, future studies comparing melphalan administered over a 24-h period and oral melphalan administrations will be scheduled.

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Management of Cancer During Pregnancy

Doll

Ringenberg²,

Yarbro³

1988

Arch Intern Med

172

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Advanced Ovarian Adenocarcinoma A Prospective Clinical Trial of Melphalan (L-PAM) Versus Combination Chemotherapy

Cited by 41 publications

References 0 publications

Second look laparotomy in the management of epithelial cell carcinoma of the ovary

Second look laparotomy in the management of epithelial cell carcinoma of the ovary

Phase II study of melphalan as a single-agent infused over a 24-hour period with individual adapted dosing in patients with recurrent epithelial ovarian cancer

Management of Cancer During Pregnancy

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