Neoadjuvant carboplatin and ifosfamide chemotherapy for inoperable FIGO stage III and IV ovarian carcinoma

Lim, Jiwon; Green, J.A.

doi:10.1016/s0936-6555(05)80227-4

Cited by 45 publications

(19 citation statements)

References 19 publications

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“…Our results are in accordance with reports of IFO/CBDCA combinations as a first-line treatment for AOC despite the fact that these series differ in terms of patient characteristics and IFO and platinum salt administration schedules [13][14][15][16]. Among these reports, the IFO dose-intensity ranged from 1.25 [14] to 3.75 g/m 2 /sem [13]. The benefit of high-dose therapy, however, cannot be assessed from these reports because of their differences; and whether dose-intense schedules are of interest in advanced ovarian cancer still remains a matter of controversy.…”

Section: Discussionsupporting

confidence: 92%

“…Although treatment delay was common, only 2 patients (who did not receive HGF) left the study due to myelosuppression. Our results are in accordance with reports of IFO/CBDCA combinations as a first-line treatment for AOC despite the fact that these series differ in terms of patient characteristics and IFO and platinum salt administration schedules [13][14][15][16]. Among these reports, the IFO dose-intensity ranged from 1.25 [14] to 3.75 g/m 2 /sem [13].…”

Section: Discussionsupporting

confidence: 91%

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A Phase I/II Study of Dose-Escalated Ifosfamide plus Carboplatin Combination for Advanced Ovarian Carcinoma

Kurtz¹,

Deplanque²,

Duclos³

et al. 1999

Oncol Res Treat

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Background: Advanced ovarian cancer is often a fatal disease, despite good initial response to chemotherapy. Dose-intense schedules have been reported, but failed to demonstratesignificant breakthrough. This study evaluates high-dose ifosfamide (IFO) plus carboplatin (CBDCA) in advanced ovarian cancer. Patients and Methods:Twenty-eight patients entered this phase I/II study. All had diagnostic laparotomy and maximal debulking if possible. IFO and CBDCA were given every 3 weeks for 6 courses or less, if there was tumor progression. IFO levels ranged from 1.8 to 3 g/m²/day days 1–3, increasing by 0.3 g/m²/ day steps, and CBDCA was administered at AUC = 6. Results: An objective response (CR + PR) was obtained in 14/26 assessable patients (53.9%). The maximally tolerated dose was reached at the 2.7 g/m²/day IFO level. Treatment had to be terminated in 5 patients (3 with myelotoxicity, 1 with encephalopathy, and 1 refusal). Median disease-free survival time was 24.5 months, median survival time was 30 months. Conclusions: A combination of IFO 2.7 g/m²/day days 1–3 and CBDCA AUC = 6 can be administered safely in patients with advanced ovarian cancer. Data indicate that both response and disease-free survival rates do not differ from standard therapy.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

A Phase I/II Study of Dose-Escalated Ifosfamide plus Carboplatin Combination for Advanced Ovarian Carcinoma

Kurtz¹,

Deplanque²,

Duclos³

et al. 1999

Oncol Res Treat

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“…An alternative to conventional surgery followed by chemotherapy is to deliver neoadjuvant chemotherapy followed by surgery. Previous small studies of neoadjuvant chemotherapy have suggested similar progression-free survival (PFS) and overall survival, as compared with initial surgery followed by chemotherapy, with reduced surgical morbidity, better optimal debulking rates, less cost and better chemotherapy tolerability [1,2,3,4,5,6]. …”

Section: Introductionmentioning

confidence: 99%

Chemotherapy Resistance as a Predictor of Progression-Free Survival in Ovarian Cancer Patients Treated with Neoadjuvant Chemotherapy and Surgical Cytoreduction Followed by Intraperitoneal Chemotherapy: A Southwest Oncology Group Study

Tiersten¹,

Moon²,

Smith³

et al. 2009

Oncology

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Purpose: In vitro testing of the activity of chemotherapeutic agents has been suggested as 1 method to optimally select drugs for patients with ovarian cancer. There are limited prospectively obtained data examining the clinical utility of this approach. We sought to obtain a preliminary assessment of this strategy in a trial that examined the administration of neoadjuvant chemotherapy followed by surgical cytoreduction and intraperitoneal chemotherapy in women with advanced ovarian cancer. Methods: Women with stage III/IV epithelial ovarian carcinoma that presented with large-volume disease were treated with neoadjuvant intravenous paclitaxel and carboplatin for three 21-day cycles followed by cytoreductive surgery. If optimally debulked, patients received intravenous paclitaxel, intraperitoneal carboplatin and intraperitoneal paclitaxel for six 28-day cycles. Tumor cloning assay results (Oncotech) were correlated with progression-free survival. Results: Sixty-two patients (58 eligible) were registered from March 2001 to February 2006. Thirty-six eligible patients had interval debulking and 26 received postcytoreduction chemotherapy. Twenty-two patients had tumor cloning assay results available. The clinical features of this population were similar to those of the larger group of women who entered this study. There was no difference in progression-free survival between patients whose cancers were defined as ‘resistant’ or ‘nonresistant’ to either platinum or paclitaxel. Conclusions: While the small patient numbers in this trial do not permit definitive conclusions, these data fail to provide support for the argument that prospectively obtained in vitro data regarding platinum or paclitaxel resistance will be highly predictive of clinical outcome in advanced ovarian cancer.

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“…(Schwartz, Chambers et al 1994) These studies also demonstrate that neoadjuvant chemotherapy is associated with lesser surgical morbidity such as blood loss, shorter operative times and shorter length of hospital and ICU stay. (Lawton, Redman et al 1989;Chambers, Chambers et al 1990;Jacob, Gershenson et al 1991;Lim and Green 1993;Schwartz, Chambers et al 1994;Vergote, De Wever et al 1998;Schwartz, Rutherford et al 1999) One retrospective study of 116 patients showed worse outcomes with neoadjuvant chemotherapy with greater survival in primary surgery group (53% vs. 30%, p=0.03). However, in this study, patients in the neoadjuvant chemotherapy group were significantly older (p<0.001), had higher grade of disease (p<0.005) and when adjusted for age and grade, patients there was no difference in overall survival (p=0.95) (Steed, Oza et al 2006).…”

Section: Discussionmentioning

confidence: 99%

Neoadjuvant Chemotherapy in Ovarian Cancer

Singh¹,

Tiersten²

2012

Neoadjuvant Chemotherapy - Current Applications in Clinical Practice

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Neoadjuvant carboplatin and ifosfamide chemotherapy for inoperable FIGO stage III and IV ovarian carcinoma

Cited by 45 publications

References 19 publications

A Phase I/II Study of Dose-Escalated Ifosfamide plus Carboplatin Combination for Advanced Ovarian Carcinoma

A Phase I/II Study of Dose-Escalated Ifosfamide plus Carboplatin Combination for Advanced Ovarian Carcinoma

Chemotherapy Resistance as a Predictor of Progression-Free Survival in Ovarian Cancer Patients Treated with Neoadjuvant Chemotherapy and Surgical Cytoreduction Followed by Intraperitoneal Chemotherapy: A Southwest Oncology Group Study

Neoadjuvant Chemotherapy in Ovarian Cancer

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