Nedaplatin and irinotecan combination therapy is equally effective and less toxic than cisplatin and irinotecan for patients with primary clear cell adenocarcinoma of the ovary and recurrent ovarian carcinoma

Abstract

Abstract. This study retrospectively compared nedaplatin and irinotecan hydrochloride (NDP/CPT) combination therapy with cisplatin and irinotecan hydrochloride therapy (CDDP/ CPT) for efficacy and adverse events in the treatment of clear cell adenocarcinoma of the ovary (CCC) and recurrent ovarian carcinoma. A total of 115 patients were included in the present study. NDP/CPT was administered intravenously every 4 weeks (NDP, 60 mg/m 2 on day 1; CPT, 50 mg/m 2 on days 1, 8 and 15). CDDP/CPT was also administered intravenously (CDDP, 60 mg/m 2 on day 1; CPT, 60 mg/m 2 on days 1, 8 and 15). Patients with primary CCC were treated with NDP/CPT in 29 cases and CDDP/CPT in 20 cases. Patients with recurrent ovarian carcinoma were treated with NDP/CPT and CDDP/ CPT in 33 cases each. No significant difference was observed in the 5-year overall survival (OS)/progression-free survival (PFS) of patients with primary CCC, with the exception of those patients with stages Ia and Ic(b) who underwent NDP/CPT and CDDP/CPT treatments (OS: 58%, PFS: 40% and OS: 53% and PFS: 47%, respectively). No significant differences were found in the response rates to NDP/CPT and CDDP/CPT in patients with recurrent ovarian carcinoma (27 and 18%, respectively). Similarly, there were no significant differences in the 5-year OS and PFS of patients with recurrent ovarian carcinoma treated with NDP/CPT or CDDP/CPT (OS: 15%, PFS: 3% and OS: 18%, PFS: 6%, respectively). In terms of the hematological toxicity of grade 3 or above and non-hematological toxicity of grade 2 or above in patients treated with NDP/CPT and CDDP/ CPT, respectively, neutropenia was 23 and 56%; anemia, 1, and 20%; thrombocytopenia, 0 and 5%; nausea, 20 and 52%; diarrhea, 14 and 25%; and fever, 2 and 11%. Accordingly, NDP/ CPT indicated mild toxicity, and was therefore equally effective and less toxic than CDDP/CPT in the treatment of primary CCC and recurrent ovarian carcinoma. IntroductionClear cell adenocarcinoma of the ovary (CCC) is defined by the World Health Organization as lesions characterized by clear cells growing in solid/tubular or glandular patterns as well as hobnail cells (1). The frequency of CCC in female individuals of Western countries is 8% (2). The frequency is higher in Japan at 15% (3). The standard first-line chemotherapy for ovarian epithelial cancer is paclitaxel-platinum combination chemotherapy (T/platinum), which has a response rate of 78% (4). However, for the treatment of CCC, the response rate is only 22-56% (5,6). As such, CCC patients have a poorer prognosis than patients with serous cystadenocarcinoma of the ovary (3). Alternative regimens for the treatment of CCC using combinations of camptothecin derivates, irinotecan hydrochloride and cisplatin (CDDP/CPT) have been investigated (7-9). CDDP/CPT has also been used as an alternative regimen for the treatment of recurrent ovarian carcinoma (10,11). CDDP/ CPT is regarded as one of the common treatments of primary CCC and recurrent ovarian carcinoma.Nedaplatin (cis-diammine glycolato platinum, NDP) ...

Risk Factors for Septic Shock After Irinotecan-Containing Chemotherapy: An Exploratory Case-Control Study

“…Irinotecan is used in chemotherapy for gynecological cancers, including cervical cancer and ovarian cancer, sometimes in combination with other cytotoxic agents, such as nedaplatin and cisplatin [ 1 , 2 ]. Irinotecan is metabolized into SN38, which is an active metabolite of carboxylesterases.…”