Dose-dense weekly chemotherapy in advanced ovarian cancer: An updated meta-analysis of randomized controlled trials

Marchetti, Cláudia; Felice, Francesca De; Pinto, Anna Di; D’Oria, Ottavia; Aleksa, Natalia; Musella, Angela; Palaia, Innocenza; Muzii, Ludovico; Tombolini, Vincenzo; Panici, Pierluigi Benedetti

doi:10.1016/j.critrevonc.2018.02.016

Cited by 22 publications

(21 citation statements)

References 13 publications

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“…Additionally, the results were not changed with HR 1.01 (95% CI 0.93-1.10) and 0.82 (95% CI 0.63-1.08), respectively, even though the analysis was limited to both weekly and semi-weekly dose-dense data [47]. Therefore, the authors believed that conventional triweekly combination chemotherapy is still one of the golden-standard treatments of patients with advanced stage ETOC [47].…”

Section: Previous Studies For Dose-dense Therapymentioning

confidence: 97%

“…The final part-which is especially useful in certain circumstances, such as in patients having optimally PCS stage II-IV diseases [26]-is the combination of IV paclitaxel 135 mg/m 2 on Day 1, intraperitoneal (IP) cisplatin 75-100 mg/m 2 on Day 2, and IV paclitaxel 60 mg/m 2 on Day 8 Q3W for 6 cycles [43,44]. Although there are so many recommendations available as shown above, now, the most frequently acceptable standard chemotherapy for ETOC and PPSC is still the use of combination of triweekly carboplatin and paclitaxel [37,[45][46][47][48][49][50][51].…”

Section: Current Standard Of Treatmentmentioning

confidence: 99%

“…Since both platinum and paclitaxel are the essential cytotoxic agents in ETOC patients after PCS, either any one or both can be administered as dose-dense protocol. Furthermore, dose-dense can be classified according to the types, including semiweekly dose-dense, in which paclitaxel was given weekly and carboplatin was given triweekly, and weekly dose dense, in which both paclitaxel and carboplatin were given weekly [47]. An accumulation dose of paclitaxel is 240-270 mg/m 2 with separating into 80-90 mg/m 2 per week compared to a single use of 175-180 mg/m 2 every three weeks.…”

Section: Rationale Of Dose-dense Therapymentioning

confidence: 99%

“…A recent meta-analysis conducted by Marchetti and colleagues further updated these four randomized controlled trials containing 3698 patients, and found that dose-dense chemotherapy did not have a statistically significant benefit of PFS (HR 0.92, 95% CI 0.81-1.04) [47]. Additionally, the results were not changed with HR 1.01 (95% CI 0.93-1.10) and 0.82 (95% CI 0.63-1.08), respectively, even though the analysis was limited to both weekly and semi-weekly dose-dense data [47]. Therefore, the authors believed that conventional triweekly combination chemotherapy is still one of the golden-standard treatments of patients with advanced stage ETOC [47].…”

Section: Previous Studies For Dose-dense Therapymentioning

confidence: 99%

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Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer

Huang

Chen

Lee

et al. 2020

IJERPH

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The use of weekly chemotherapy for the treatment of patients with advanced-stage serous-type epithelial Tubo-ovarian cancer (ETOC), and primary peritoneal serous carcinoma (PPSC) is acceptable as the front-line postoperative chemotherapy after primary cytoreductive surgery (PCS). The main component of dose-dense chemotherapy is weekly paclitaxel (80 mg/m2), but it would be interesting to know what is the difference between combination of triweekly cisplatin (20 mg/m2) or triweekly carboplatin (carboplatin area under the curve 5-7 mg/mL per min [AUC 5-7]) in the dose-dense paclitaxel regimen. Therefore, we compared the outcomes of women with Gynecology and Obstetrics (FIGO) stage IIIC ETOC and PPSC treated with PCS and a subsequent combination of dose-dense weekly paclitaxel and triweekly cisplatin (paclitaxel–cisplatin) or triweekly carboplatin using AUC 5 (paclitaxel–carboplatin). Between January 2010 and December 2016, 40 women with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC EOC, FTC, or PPSC were enrolled, including 18 treated with paclitaxel–cisplatin and the remaining 22 treated with paclitaxel–carboplatin. There were no statistically significant differences in disease characteristics of patients between two groups. Outcomes in paclitaxel–cisplatin group seemed to be little better than those in paclitaxel–carboplatin (median progression-free survival [PFS] 30 versus 25 months as well as median overall survival [OS] 58.5 versus 55.0 months); however, neither reached a statistically significant difference. In terms of adverse events (AEs), patients in paclitaxel–carboplatin group had more AEs, with a higher risk of neutropenia and grade 3/4 neutropenia, and the need for a longer period to complete the front-line chemotherapy, and the latter was associated with worse outcome for patients. We found that a period between the first-time chemotherapy to the last dose (6 cycles) of chemotherapy >21 weeks was associated with a worse prognosis in patients compared to that ≤21 weeks, with hazard ratio (HR) of 81.24 for PFS and 9.57 for OS. As predicted, suboptimal debulking surgery (>1 cm) also contributed to a worse outcome than optimal debulking surgery (≤1 cm) with HR of 14.38 for PFS and 11.83 for OS. Based on the aforementioned findings, both regimens were feasible and effective, but maximal efforts should be made to achieve optimal debulking surgery and following the on-schedule administration of dose-dense weekly paclitaxel plus triweekly platinum compounds. Randomized trials validating the findings are warranted.

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Section: Previous Studies For Dose-dense Therapymentioning

confidence: 97%

Section: Current Standard Of Treatmentmentioning

confidence: 99%

Section: Rationale Of Dose-dense Therapymentioning

confidence: 99%

Section: Previous Studies For Dose-dense Therapymentioning

confidence: 99%

See 2 more Smart Citations

Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer

Huang

Chen

Lee

et al. 2020

IJERPH

View full text Add to dashboard Cite

show abstract

“…However, there are still inherent limitations of chemotherapy, including low efficacy, nonspecific distribution, and other undesirable adverse effects. [3][4][5] Hence, methodological improvements, such as developing a targeted, efficient, and safe drug delivery system (DDS) applied in chemotherapy are urgently required.…”

Section: Introductionmentioning

confidence: 99%

<p>Extracellular Vesicles – Advanced Nanocarriers in Cancer Therapy: Progress and Achievements</p>

Huyan¹,

Li²,

Peng³

et al. 2020

IJN

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Extracellular vesicles (EVs) are a class of cell-derived, lipid bilayer membrane composed vesicles, and some of them such as exosomes and ectosomes have been proven, playing remarkable roles in transmitting intercellular information, and being involved in each property of cell physiological activities. Nowadays, EVs are considered as potential nanocarriers which could partially resolve the problems of current chemotherapy because of their distinctive advantages. As endogenous membrane encompassed vesicles with nanosize, EVs are able to pass through the natural barriers with prolonged circulation time in vivo and have intrinsic cell targeting properties, they are less toxic, and less immunogenic. Recently, studies focusing on EV-based drug delivery system for cancer therapy have exploded dramatically. This review aims to outline the current applications of EVs as potential nanosized drug carriers in cancer therapy. Firstly, the characteristics and biofunctions of each EV subtype are described. Then the variety of therapeutic cargoes, the loading methods, and the targeting strategy of engineered EVs are emphatically introduced. Thereafter the pros and cons of EVs applied as therapeutic carriers, as well as the future prospects in this field, are discussed.

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Weekly versus tri-weekly paclitaxel with carboplatin for first-line treatment in women with epithelial ovarian cancer

Ngoi

Syn

Goh

et al. 2022

Cochrane Database of Systematic Reviews

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Dose-dense weekly chemotherapy in advanced ovarian cancer: An updated meta-analysis of randomized controlled trials

Cited by 22 publications

References 13 publications

Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer

Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer

<p>Extracellular Vesicles – Advanced Nanocarriers in Cancer Therapy: Progress and Achievements</p>

Weekly versus tri-weekly paclitaxel with carboplatin for first-line treatment in women with epithelial ovarian cancer

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