Phase II trial of Oxaliplatin and 5-Fluorouracil/Leucovorin combination in epithelial ovarian carcinoma relapsing within 2 years of platinum-based therapy

Sundar, Santhanam; Symonds, R.P.; Decatris, Marios P.; Kumar, Dinesh; Osman, A. E.; Vasanthan, Subramaniam; O’Byrne, Kenneth J.

doi:10.1016/j.ygyno.2004.04.020

Cited by 28 publications

(21 citation statements)

References 33 publications

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“…A longer PFS and OS was also observed for patients with Ki67 below 55% (Faggiano et al 2007, Sorbye et al 2012 in the univariate analysis. Interestingly, some patients who failed to respond to first-line platinum therapy responded or were stabilized under FOLFOX as reported previously for ovarian cancer (Pectasides et al 2004, Sundar et al 2004 and also in germ cell tumors (Theodore et al 2008). However, whether this efficacy in cisplatin-resistant tumors is due to oxaliplatin alone or its combination with other agents such as 5-FU (FOLFOX) or gemcitabine (GEMOX) remains unknown (Stordal et al 2007).…”

Section: Discussionmentioning

confidence: 85%

Post-first-line FOLFOX chemotherapy for grade 3 neuroendocrine carcinoma

Hadoux¹,

Malka²,

Planchard³

et al. 2015

Endocrine-Related Cancer

128

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There is no standard for second-line chemotherapy in poorly differentiated grade 3 neuroendocrine carcinoma (G3-NEC) patients. We analyzed the antitumor efficacy of 5-fluorouracil and oxaliplatin (FOLFOX) chemotherapy in this population. A single-center retrospective analysis of consecutive G3-NEC patients treated with FOLFOX chemotherapy after failure of a cisplatinum-based regimen between December 2003 and June 2012 was performed. Progression-free survival (PFS), overall survival (OS), response rate, and safety were assessed according to RECIST 1.1 and NCI.CTC v4 criteria. Twenty consecutive patients were included (seven males and 13 females; median age 55; range 23-87 years) with a performance status of 0-1 in 75% of them. Primary location was gastroenteropancreatic in 12, thoracic in four, other in two, and unknown in two patients. There were 12 (65%) large-cell and 7 (30%) small-cell G3-NEC tumors, and 1 (5%) unknown. All patients had distant metastases. Twelve (60%) patients received FOLFOX as second-line treatment and 8 (40%) as third-line treatment or later and the median number of administered cycles was 6 (range 3-14). The median follow-up was 19 months. Median PFS was 4.5 months. Among the 17 evaluable patients, five partial responses (29%), six stable diseases (35%), and six progressive diseases (35%) were observed. Median OS was 9.9 months. Main Grade 3-4 toxicities were neutropenia (35%), thrombopenia (20%), nausea/vomiting (10%), anemia (10%), and elevated liver transaminases (10%). Our results indicate that the FOLFOX regimen could be considered as a second-line option in poorly differentiated G3-NEC patients after cisplatinum-based first-line treatment but warrant further confirmation in future larger prospective studies. Key Words" neuroendocrine carcinoma

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Section: Discussionmentioning

confidence: 85%

Post-first-line FOLFOX chemotherapy for grade 3 neuroendocrine carcinoma

Hadoux¹,

Malka²,

Planchard³

et al. 2015

Endocrine-Related Cancer

128

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“…In advanced breast cancer, capecitabine is one of the standard drugs for anthracycline-pretreated patients [15,16]. Although they are not regarded as standard treatment in these diseases, 5-FU plus oxaliplatin have been shown to be active in breast cancer [17,18] and advanced ovarian cancer [19]. In non-small cell lung cancer, the oral fluoropyrimidine uracil/tegafur (UFT) had some positive results in Asian patients [20], as well as oxaliplatin as monotherapy or in combination with gemcitabine [21,22].…”

Section: Discussionmentioning

confidence: 99%

Phase II Trial of Capecitabine and Oxaliplatin in Patients with Adeno- and Undifferentiated Carcinoma of Unknown Primary

et al. 2009

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Background: Carcinomas of unknown primary (CUP) account for approximately 2–5% of all cancer diagnoses. Except for some subsets with favorable prognosis, for most of these patients treatment options are limited, and no standard first-line regimen has been identified. We performed a phase II study with oxaliplatin (OX) and capecitabine (CAP) as first-line treatment for patients with histo-or cytologically proven adeno- or undifferentiated CUP. Patients and Methods: Protocol treatment in this multicenter trial consisted of CAP 1,000 mg/m² twice daily orally (days 1–14) and OX 130 mg/m² intravenously (day 1), repeated every 21 days at a maximum of 6 cycles. The primary endpoint was the response rate (RR). Secondary endpoints were progression-free survival (PFS), overall survival (OS), and safety. Results: 51 patients with CUP (71% with poorly differentiated adenocarcinoma; 41% ECOG performance status (PS) 0, 39% PS 1, 10% PS 2, 55% with elevated lactate dehydrogenase (LDH), and 39% with liver metastases) were enrolled in this study. We observed an objective RR of 11.7% and a median PFS of 2.5 months as well as an OS of 7.5 months with a good toxicity profile. Conclusion: CAP/OX did not reach higher RR compared to a standard regimen with paclitaxel/carboplatin, which discourages further investigation of this schedule in CUP.

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“…Four studies have demonstrated reasonable efficacy with an acceptable toxicity profile of FOLFOX (5FU/leucovorin + oxaliplatin) in platinum resistant, heavily pre-treated EOC [85][86][87][88] (Table 6). Again, these studies were all in the second-line or beyond setting and included only a handful of mEOC patients, so it is difficult to draw conclusions.…”

Section: Fu/leucovorin and Oxaliplatin (Folfox)mentioning

confidence: 99%

Mucinous ovarian cancer: A therapeutic review

Wen

Rush

Rickett

et al. 2016

Critical Reviews in Oncology/Hematology

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Highlights Mucinous epithelial ovarian cancer (mEOC) is a rare chemo-resistant subtype of ovarian cancer with distinct epidemiology, pathology and natural history.  mEOC can often masquerade as metastatic mucinous tumours from the gastrointestinal (GI) tract.  Molecularly, in contrast to high-grade serous ovarian cancer (HGSOC), mEOC are far less defined by p53 mutations and instead commonly harbour KRAS and HER 2 mutations.  The current gold standard of 1 st line platinum/taxane doublet chemotherapy, is more tailored towards HGSOC and generally ineffective for mEOC.  This review summarises the limited evidence for using GI style chemotherapeutic agents in treating mEOC and explores novel therapeutic possibilities such as targeting HER2, VEGF and Src. AbstractMucinous ovarian cancer represents approximately 3% of epithelial ovarian cancers (EOC).Despite this seemingly low prevalence, it remains a diagnostic and therapeutic conundrum that has resulted in numerous attempts to adopt novel strategies in managing this disease.Anecdotally, there has been a prevailing notion that established gold standard systemic regimens should be substituted for those utilised in cancers such as gastrointestinal (GI) malignancies; tumours that share more biological similarities than other EOC subtypes. This review summarises the plethora of small studies which have adopted this philosophy and influenced the design of the multinational GOG142 study, which was ultimately terminated due to poor accrual. To date, there is a paucity of evidence to support delivering 'GI style' chemotherapy for mucinous ovarian cancer over and above carboplatin-paclitaxel doublet therapy. Hence there is an urge to develop studies focused on targeted therapeutic agents driven by refined mutational analysis and conducted within the context of harmonised international collaborations.3

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Phase II trial of Oxaliplatin and 5-Fluorouracil/Leucovorin combination in epithelial ovarian carcinoma relapsing within 2 years of platinum-based therapy

Cited by 28 publications

References 33 publications

Post-first-line FOLFOX chemotherapy for grade 3 neuroendocrine carcinoma

Post-first-line FOLFOX chemotherapy for grade 3 neuroendocrine carcinoma

Phase II Trial of Capecitabine and Oxaliplatin in Patients with Adeno- and Undifferentiated Carcinoma of Unknown Primary

Mucinous ovarian cancer: A therapeutic review

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