The combination of gemcitabine and carboplatin shows similar efficacy in the treatment of platinum-resistant and platinum-sensitive recurrent epithelial ovarian cancer patients

Abstract

The aim of this study was to evaluate progression-free survival, overall survival (OS), response rate (RR), and clinical benefit in recurrent ovarian cancer patients treated with gemcitabine and carboplatin and to compare the outcome among platinum-resistant and platinum-sensitive patients. A retrospective study using the medical records of patients diagnosed and treated for recurrent epithelial ovarian cancer, fallopian tube carcinoma, or primary peritoneal carcinoma with gemcitabine and carboplatin from 2005 through 2012 at the Tel Aviv Sourasky Medical Center. The treatment regimen was carboplatin (area under the curve=5) administered on day 1 and gemcitabine 850 mg/m administered on days 1 and 8 in a 21-day cycle. Seventy patients with a median age of 57 years (range: 38-86) were included in the study. Most patients (94.3%) were initially diagnosed with stage III-IV disease and 44.3% had platinum-sensitive disease. Median progression-free survival in platinum-sensitive patients was 6.3 months [95% confidence interval (CI): 4.3-8.3] and 6.3 months (95% CI: 4.6-7.9) in platinum-resistant patients. Median overall survival was 15.8 months (95% CI: 13.6-18.1) in the platinum-sensitive patients and 18.4 months (95% CI: 10.0-27.8) in the platinum-resistant patients. Platinum-sensitive patients had a RR of 43.2% and platinum-resistant patients had a RR of 39.1%. The clinical benefit was 70.5% in platinum-sensitive patients and 65.2% in platinum-resistant patients. Overall treatment had a favorable safety profile. Gemcitabine and carboplatin demonstrate moderate toxicity with similar efficacy in both platinum-sensitive and platinum-resistant epithelial ovarian cancer, suggesting reversal of platinum resistance by gemcitabine.

Cytoreduction surgery with hyperthermic intraperitoneal chemotherapy in recurrent ovarian cancer improves progression‐free survival, especially in BRCA‐positive patients—A case‐control study

“…There were no major bleeding events or peri‐operative mortality. The toxicity of the systemic chemotherapy is well known and has been previously described by us .…”

Prognostic Impact of Human Leukocyte Antigen Class I Expression and Association of Platinum Resistance with Immunologic Profiles in Epithelial Ovarian Cancer

“…Gemcitabine, which is commonly used in second-line to third-line chemotherapy for EOC, has been shown to decrease DNA repair in vitro (38). Safra and colleagues (39) report that response rates to the combination of gemcitabine and carboplatin were the same in platinum-sensitive patients and platinum-resistant patients with recurrent EOC (43.2% vs. 39.1%). Bevacizumab, the first reported effective molecular target agent of ovarian cancer, is expected to be effective for platinum-resistant EOC, and several studies using this agent have been conducted or are ongoing (40).…”

Gemcitabine‐(5′‐phosphoramidate)‐[anti‐IGF‐1R]: molecular design, synthetic organic chemistry reactions, and antineoplastic cytotoxic potency in populations of pulmonary adenocarcinoma (A549)

“…Neoplastic cell types known to be relatively sensitive to the biological activity of gemcitabine include pancreatic carcinoma, ovarian carcinoma, small‐cell lung carcinoma, non‐small cell lung carcinoma, neuroblastoma, and leukemia/lymphoid populations. Similarly, human promyelocytic leukemia, T‐4 lymphoblastoid clones, glioblastoma, cervical epithelioid carcinoma, colon adenocarcinoma, pancreatic adenocarcinoma, pulmonary adenocarcinoma, oral squamous cell carcinoma, and prostatic carcinoma have been found to be sensitive to gemcitabine and covalent gemcitabine‐(oxyether phopholipid) preparations.…”

“…antineoplastic cytotoxic potency, covalent immunochemotherapeutic, gemcitabine, IGF-1R, margin-ofsafety, selective 'targeted' delivery, synergistic efficacy,synthesis 1 Department of Basic Sciences, College of ovarian carcinoma, [14,15] while preliminary investigations indicated it may also be beneficial for the therapeutic management of esophageal cancer and leukemia/lymphoma. [16][17][18] Gemcitabine in dual combination with fludarabine exerts synergistic antineoplastic properties.…”

“…Many conventional chemotherapeutics are capable of effectively resolving B‐CLL, but dose‐limiting sequelae often compromise attaining this treatment objective. In field of clinical oncology, gemcitabine is primarily administered for the therapeutic management of various carcinomas including non‐small cell pulmonary carcinoma, pancreatic carcinoma, renal carcinoma, urinary bladder carcinoma, breast cancer, prostatic carcinoma, and ovarian carcinoma, while preliminary investigations indicated it may also be beneficial for the therapeutic management of esophageal cancer and leukemia/lymphoma . Gemcitabine in dual combination with fludarabine exerts synergistic antineoplastic properties .…”