Intravenous treosulfan versus intravenous treosulfan plus cisplatinum in advanced ovarian carcinoma

Masding, J.; Sarkar, T. K.; White, William F.; Barley, V.; Chawla, Shanta; Boesen, Evelyn; Rostom, A.Y.; Menday, A. P.

doi:10.1111/j.1471-0528.1990.tb01813.x

Cited by 35 publications

(14 citation statements)

References 9 publications

(5 reference statements)

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“…Single-agent non-platinum vs platinum-based combination chemotherapy Data were available from a total of 11 trials including 1329 patients and 1169 deaths (Bell et al, 1982;Decker et al, 1982;Sturgeon et al, 1982;Williams et al, 1985; Gynaecological Group COSA, 1986;Wilbur et al, 1987;Leonard et al, 1989;Masding et al, 1990;Wadler et al, 1996;MRC Gynaecological Cancer Working Party, unpublished data;Crowther, unpublished data). Data were not available for two trials (99 patients) (Harvey et al, 1982;De Oliveira et al, 1990).…”

Section: Resultsmentioning

confidence: 99%

Chemotherapy in advanced ovarian cancer: four systematic meta-analyses of individual patient data from 37 randomized trials

Aabo¹,

Adams²,

Adnitt³

et al. 1998

Br J Cancer

210

100

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Summary The purpose of this systematic study was to provide an up to date and reliable quantitative summary of the relative benefits of various types of chemotherapy (non-platinum vs platinum, single-agent vs combination and carboplatin vs cisplatin) in the treatment of advanced ovarian cancer. Also, to investigate whether well-defined patient subgroups benefit more or less from cisplatin-or carboplatinbased therapy. Meta-analyses were based on updated individual patient data from all available randomized controlled trials (published and unpublished), including 37 trials, 5667 patients and 4664 deaths. The results suggest that platinum-based chemotherapy is better than nonplatinum therapy, show a trend in favour of platinum combinations over single-agent platinum, and suggest that cisplatin and carboplatin are equally effective. There is no good evidence that cisplatin is more or less effective than carboplatin in any particular subgroup of patients.Keywords: meta-analysis; systematic review; randomized controlled trials; advanced ovarian cancer; chemotherapy Health care professionals and patients alike are becoming increasingly aware of the need to make medical decisions on the basis of up-to-date, objective and unbiased research (Chalmers and Haynes, 1994). The most reliable information results from randomized controlled trials (RCTs). Unfortunately, most RCTs, including those conducted in ovarian cancer, have been too small to demonstrate moderate treatment benefits with reliability, and many results have been inconclusive or contradictory. The Advanced Ovarian Cancer Trialists Group (AOCTG) recognized that the best means of synthesizing such randomized evidence is by systematic meta-analysis. In 1988, five meta-analyses of chemotherapy in advanced ovarian cancer using updated individual patient data were initiated. The first results were published in 1991 (AOCTG, 1991). The AOCTG recognized the importance of updating these results especially for the comparison of carboplatin and cisplatin, in which the data were relatively immature. The comparison of platinum analogues was considered of such clinical importance that further new investigations were initiated to identify whether any particular type of women or tumour would benefit more from either cisplatin-or carboplatin-based chemotherapy. PATIENTS AND METHODSTrials were eligible for inclusion provided they examined first-line chemotherapy for advanced ovarian cancer, were properly randomized and made one of the treatment comparisons described below. Trials were identified by bibliographic searches using MEDLINE and CancerLit, by hand searching relevant meeting proceedings and by consulting trial registers (AOCTG, 1991). Both published and unpublished trials were included and updated data were sought for all randomized patients. All data were checked thoroughly and the final database entries for each trial were verified by the responsible trialist or data centre.All analyses were based on intention to treat. Survival analyses were stratified by trial, and t...

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Section: Resultsmentioning

confidence: 99%

Chemotherapy in advanced ovarian cancer: four systematic meta-analyses of individual patient data from 37 randomized trials

Aabo¹,

Adams²,

Adnitt³

et al. 1998

Br J Cancer

210

100

View full text Add to dashboard Cite

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“…A total of 8 were transfusion dependent, and 5 already had decreased platelet counts at the beginning of the conditioning. Overall, leukocytes recovered to higher than 1.0 ϫ 10 9 /L at a median of day 10 (range, days 4-19), neutrophils reached 0.5 ϫ 10 9 /L at a median of day 11.5 (range, days [6][7][8][9][10][11][12][13][14][15][16][17][18][19], and platelets exceeded 50 ϫ 10 9 /L by a median of day 18 (range, days 9-35).…”

Section: Engraftment and Chimerismmentioning

confidence: 99%

“…8,9 Hematotoxicity is dose limiting in conventional therapy. 10 Only recently, in two phase 1 protocols with autologous blood stem cell rescue, was it possible to escalate the dose to almost 5 times the maximum tolerated dose defined by conventional therapy before mucositis/ stomatitis, diarrhea, skin toxicity, and acidosis became dose limiting.…”

Section: Introductionmentioning

confidence: 99%

Treosulfan and fludarabine: a new toxicity-reduced conditioning regimen for allogeneic hematopoietic stem cell transplantation

Casper

Knauf

Kiefer

et al. 2004

Blood

136

147

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“…[8][9][10][11] It is approved for the treatment of ovarian carcinoma in a number of European countries. 12,13 Since the early 1980s, clinical studies with the i.v. formulation of treosulfan have been conducted predominantly in patients with ovarian cancer as a single drug or in combination with other cytotoxic drugs, such as cisplatin or gemcitabin.…”

Section: Treosulfan: Clinical Pharmacologymentioning

confidence: 99%

“…formulation of treosulfan have been conducted predominantly in patients with ovarian cancer as a single drug or in combination with other cytotoxic drugs, such as cisplatin or gemcitabin. 12,13 The conventional tolerated doses were 5-8 g/m 2 i.v. The most common toxicity is hematological, which limits the maximal tolerated dose to 10 g/m 2 every 4 weeks.…”

Section: Treosulfan: Clinical Pharmacologymentioning

confidence: 99%

Treosulfan-based conditioning before hematopoietic SCT: more than a BU look-alike

Danylesko

Shimoni

Nagler

2011

Bone Marrow Transplant

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Allogeneic hematopoietic SCT is a curative treatment for a variety of hematological malignancies and genetic diseases. There is a continuous search for novel conditioning regimens that will reduce SCT-related toxicity while retaining maximal antimalignancy effect. Treosulfan (L-threitol-1,4-bis-methanesulfonate; dihydroxybusulfan) was initially used in the treatment of certain solid tumors. Preclinical studies showed that it has a myeloablative effect on committed and non-committed stem cells. It has potent immunosuppressive characteristics, more prominent than its related chemotherapy agent BU, which makes it an attractive candidate for the use in conditioning regimens before allo-SCT. It is also associated with a favorable toxicity profile with little extramedullary toxicity. The combination of fludarabine and treosulfan was explored in several studies in patients not eligible for standard myeloablative conditioning, and data are rapidly emerging. This regimen is associated with consistent engraftment. A limited non-relapse mortality (NRM) rate in the range of 9-28% was observed. This rate is promising considering the patients selected and results from low rates of organ toxicity as well as acute and chronic GVHD. The regimen was also associated with low relapse rates of 5-30% depending on disease status at SCT. Together with low NRM rate, this resulted in favorable survival in the range of 40-80%. Promising results were seen in myelodysplastic syndrome (survival 36-70%) and leukemia in remission (60-70%). Randomized prospective studies will be needed to better define the role of treosulfan-based regimens in SCT.

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Intravenous treosulfan versus intravenous treosulfan plus cisplatinum in advanced ovarian carcinoma

Cited by 35 publications

References 9 publications

Chemotherapy in advanced ovarian cancer: four systematic meta-analyses of individual patient data from 37 randomized trials

Chemotherapy in advanced ovarian cancer: four systematic meta-analyses of individual patient data from 37 randomized trials

Treosulfan and fludarabine: a new toxicity-reduced conditioning regimen for allogeneic hematopoietic stem cell transplantation

Treosulfan-based conditioning before hematopoietic SCT: more than a BU look-alike

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