Are there candidates for high-dose chemotherapy in ovarian carcinoma?

Sabatier, Renaud; Gonçalvès, Anthony; Bertucci, François; Capiello, Maria-Antonietta; Rousseau, Frédérique; Lambaudie, Éric; Chabannon, Christian; Viens, Patrice; Extra, Jean-Marc

doi:10.1186/1756-9966-31-87

Cited by 8 publications

(3 citation statements)

References 40 publications

(38 reference statements)

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“…More recently, a retrospective study ( 80 ) evaluated interest in the use of HDCT as consolidation therapy after surgery and taxane- and platinum-based therapy. In that study, 103 patients with advanced ovarian carcinoma were treated with conventional chemotherapy while 60 patients received HDCT with hematopoietic stem cell support.…”

Section: High-dose Chemotherapy To Treat Breast and Ovarian Cancermentioning

confidence: 99%

Intensive chemotherapy as salvage treatment for solid tumors: focus on germ cell cancer

Selle

Gligorov

Richard³

et al. 2015

Braz J Med Biol Res

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Germ cell tumors present contrasting biological and molecular features compared to many solid tumors, which may partially explain their unusual sensitivity to chemotherapy. Reduced DNA repair capacity and enhanced induction of apoptosis appear to be key factors in the sensitivity of germ cell tumors to cisplatin. Despite substantial cure rates, some patients relapse and subsequently die of their disease. Intensive doses of chemotherapy are used to counter mechanisms of drug resistance. So far, high-dose chemotherapy with hematopoietic stem cell support for solid tumors is used only in the setting of testicular germ cell tumors. In that indication, high-dose chemotherapy is given as the first or late salvage treatment for patients with either relapsed or progressive tumors after initial conventional salvage chemotherapy. High-dose chemotherapy is usually given as two or three sequential cycles using carboplatin and etoposide with or without ifosfamide. The administration of intensive therapy carries significant side effects and can only be efficiently and safely conducted in specialized referral centers to assure optimum patient care outcomes. In breast and ovarian cancer, most studies have demonstrated improvement in progression-free survival (PFS), but overall survival remained unchanged. Therefore, most of these approaches have been dropped. In germ cell tumors, clinical trials are currently investigating novel therapeutic combinations and active treatments. In particular, the integration of targeted therapies constitutes an important area of research for patients with a poor prognosis.

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Section: High-dose Chemotherapy To Treat Breast and Ovarian Cancermentioning

confidence: 99%

Intensive chemotherapy as salvage treatment for solid tumors: focus on germ cell cancer

Selle

Gligorov

Richard³

et al. 2015

Braz J Med Biol Res

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“…Ferrandina et al . [22] and Sabatier et al [25] found that 67.3% and 59.2% of cases were of grade III, respectively. Others, found 50% of cases were of stage III, while Yoshikawa et al [26] reported 45.7% of cases were of stage I.…”

Section: Discussionmentioning

confidence: 94%

Significant role of Loss or Reduced BRCA1 gene expression in clinical implication of ovarian cancer

Al-Kashwan¹,

Al-Bedairi

Al-Midhaffer

2021

KMJ

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Background: BRCA1 immunohistochemistry (IHC) provides a rapid initial screen to detect BRCA1 dysfunction in ovarian cancer that resulting from genetic alterations. Aim: To assess the expression of BRCA1 protein by IHC analysis among a group of Iraqi ovarian cancer patients to evaluate the patterns of expression and its correlation with the clinicopathological parameters in attempting to evaluate a significance role of BRCA1 gene implication in ovarian cancer. Methods: Forty three paraffin embedded samples of ovarian cancer cases were analyzed for BRCA1dysfunction by IHC analysis. The semi-quantitative approach using modified histochemical score (H-score) was achieved to assess the patterns of BRCA1 gene expression. Results: Complete loss of BRCA1 nuclear expression was detected in 30.2% of the cases while, reduced expression occurred in 46.5% of cases, giving rise to 76.7% of all cases detected with altered BRCA1 nuclear expression. Altered BRCA1 expression was found to be higher in age group ≤ 45 years (78.3%) in comparison with those of ages >45 years. Altered BRCA1 expression was significantly correlated with the high grade and with the unilateral tumor site when compared with the low grade and bilateral tumor site (P≤0.05), and was insignificantly correlated with the high stage ovarian tumors, 11.6% of cases were detected by cytoplasmic BRCA1 expression and no association was found between cytoplasmic expression and tumor grade, stage and tumor site. Conclusion: Altered BRCA1 expression may play a significant role in the progression of ovarian cancer. Recommendation: BRCA1 IHC is a clinically useful approach to detect the BRCA1 dysfunction and the H-score assessment reflects good estimation for BRCA1expression patterns.

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“…Similarly, as salvage therapy for refractory patients, high response rates were achieved with HDCT with stem cell support, although the response durations were short [16,17,18,19]. However, it is important to mention the fact that studies using HDCT for the treatment of ovarian cancer have contributed to show that not all patients are likely to benefit from such an approach [20,21]. …”

Section: Introductionmentioning

confidence: 99%

A Phase I Trial of High-Dose Chemotherapy Combining Topotecan plus Cyclophosphamide with Hematopoietic Stem Cell Transplantation for Ovarian Cancer: The ITOV 01bis Study

et al. 2015

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Background: Dose-intensive chemotherapy with hematopoietic stem cell transplantation has been evaluated as a salvage treatment for recurrent ovarian cancer, but its benefit has not yet been demonstrated. In a previous phase I trial, we reported the feasibility of administering topotecan as a salvage regimen. Methods: Twenty-one patients were treated with escalating doses of topotecan associated with a fixed dose of cyclophosphamide. Results: The maximum tolerated dose was established at 9.0 mg/m² on a 5-day regimen, analogously to what was reported for topotecan monotherapy. One toxic death from septic shock and multiorgan failure occurred. Although hematopoietic toxicities were overcome by peripheral blood stem cell transplantation, superior nonhematological toxicities were observed as compared to the initial trial. Conclusion: Response rates were generally short and survival rates were poor. Results of the ITOV 01bis study demonstrate that, in the setting of recurrent ovarian cancer, intensive chemotherapy based on topotecan-cyclophosphamide association is not currently clinically indicated.

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Are there candidates for high-dose chemotherapy in ovarian carcinoma?

Cited by 8 publications

References 40 publications

Intensive chemotherapy as salvage treatment for solid tumors: focus on germ cell cancer

Intensive chemotherapy as salvage treatment for solid tumors: focus on germ cell cancer

Significant role of Loss or Reduced BRCA1 gene expression in clinical implication of ovarian cancer

A Phase I Trial of High-Dose Chemotherapy Combining Topotecan plus Cyclophosphamide with Hematopoietic Stem Cell Transplantation for Ovarian Cancer: The ITOV 01bis Study

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