Topotecan versus paclitaxel for the treatment of recurrent epithelial ovarian cancer.

Huinink, W. Ten Bokkel; Gore, Martin; Carmichael, James; Gordon, Alan N.; Malfetano, John H.; Hudson, I.; Broom, Colin; Scarabelli, C; Davidson, N.; Spanczynski, M; Bolis, Giorgio; Malmström, Henric; Coleman, Robert L.; Fields, Shannon; Héron, J. F.

doi:10.1200/jco.1997.15.6.2183

Cited by 615 publications

(308 citation statements)

References 14 publications

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“…It is refreshing that at a time when most oncologists wish to give more intense combination therapy and are extending the number of courses, a less intense regimen dose appears not to be deleterious. Single-agent topotecan has been investigated extensively for its use in relapsed ovarian cancer, with response rates in platinum-sensitive patients ranging between 13 and 33% (Creemers et al, 1996;ten Bokkel Huinink et al, 1997;Bookman et al, 1998;Gore et al, 2002). Much work has also been carried out on whether using topotecan in first relapse can increase the platinum-free interval, and thus subsequent responses rates to platinum-containing regimens.…”

Section: Discussionmentioning

confidence: 99%

A phase II study of sequential carboplatin, paclitaxel and topotecan in patients with previously untreated advanced ovarian cancer

et al. 2004

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We evaluated the sequential use of carboplatin, paclitaxel and topotecan in patients with advanced, previously untreated ovarian cancer. In total, 43 patients with advanced ovarian cancer and 41 cm residual disease were treated with sequential carboplatin (areaunder-the-curve (AUC) 5 days 1 and 22), paclitaxel (175 mg m À2 days 43 and 64) and topotecan (1.5 mg m À2 daily for 5 days from days 85, 106, 127 and 148). Median age of patients was 61 years. Median follow-up was 22.2 months (range 0.76 -50.6 months). In all, 34 (79%) patients received all eight cycles of treatment and nine (21%) withdrew. Of the 29 evaluable patients, 19 (66%) responded according to WHO and 30 of 36 (83%) patients according to CA125. The best overall response (CA125 and/or WHO) was 77% (33 of 43 patients). The response rates to sequential drugs based on 450% fall in CA125 were as follows: carboplatin, 77% (30 of 39 patients); paclitaxel, 65% (15 of 23 patients); topotecan, 38% (five of 13 patients). Two patients responded to paclitaxel and one to topotecan after failure to respond to preceding chemotherapy. Median survival and time to progression was 22.24 and 10.61 months, respectively. This study demonstrates that sequential chemotherapy with just two initial courses of carboplatin is a reasonable way to introduce new agents into first-line therapy for poor prognostic ovarian cancer patients.

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Section: Discussionmentioning

confidence: 99%

A phase II study of sequential carboplatin, paclitaxel and topotecan in patients with previously untreated advanced ovarian cancer

et al. 2004

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“…26 Topotecan showed clinical activity against cisplatin-refractory ovarian cancer, with response rates of ϳ20%, which is one of the highest activities of any chemotherapeutic agents against this disease. 17,27,28 The most common adverse event described with topotecan was myelosuppression, with up to 92% of patients experiencing grade 3 or 4 neutropenia and 67% experiencing grade 3 or 4 thrombocytopenia. 17,27,29 The median durations for grades 3 and 4 neutropenia and thrombocytopenia were 10 and 5 days, respectively.…”

Section: Topotecanmentioning

confidence: 99%

“…17,27,28 The most common adverse event described with topotecan was myelosuppression, with up to 92% of patients experiencing grade 3 or 4 neutropenia and 67% experiencing grade 3 or 4 thrombocytopenia. 17,27,29 The median durations for grades 3 and 4 neutropenia and thrombocytopenia were 10 and 5 days, respectively. 18 Maculopapular pruritic exanthema occurred in 20% of patients.…”

Section: Topotecanmentioning

confidence: 99%

Thymidine kinase gene therapy with concomitant topotecan chemotherapy for recurrent ovarian cancer

et al. 2000

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“…14 Topotecan is currently approved as a second-line therapy for advanced ovarian and small cell lung carcinomas. 25,26 Because both docetaxel and topotecan have single-agent activity against solid tumors, a rationale to combine these two agents with their novel mechanisms of action has emerged. A preclinical study of SKBr-3 cell lines showed that the combination of topotecan and docetaxel is synergistic when docetaxel is administered at the time of the highest topotecaninduced G 2 -phase cell arrest.…”

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confidence: 99%

Phase I evaluation of docetaxel and topotecan for patients with advanced solid tumors

Tsao

Shin

Palmer

et al. 2004

Cancer

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BACKGROUNDThe authors administered a combination of docetaxel and topotecan with granulocyte–colony‐stimulating factor (G‐CSF) support in a Phase I study to define the maximum tolerated dose (MTD) of this regimen.METHODSPatients with advanced‐stage solid tumors were eligible for this trial if they had a Zubrod performance status of ≤ 2 and normal renal, hepatic, and bone marrow function. No previous therapy with taxanes or topoisomerase inhibitors was allowed. The authors administered both docetaxel and topotecan in a dose‐escalated manner until the MTD was reached. Docetaxel was given on Day 1 of each cycle before topotecan, which was administered intravenously on Days 1–3. Granulocyte–colony‐stimulating factor (G‐CSF) support with 5 μg/kg subcutaneous injections was initiated on Day 4 and continued until the absolute granulocyte count recovered to 2000/μL. Treatment cycles were repeated every 21 days.RESULTSOf the 11 patients enrolled in the current study, all were evaluable for toxicity and 10 were evaluable for response. A median of three treatment cycles was received (range, one to nine treatment cycles). The dose‐limiting toxicity was Grade 4 (according to the National Cancer Institute Common Toxicity Criteria for Adverse Events [version 2.0]). neutropenia with fever. The MTD was 75 mg/m2 of docetaxel on Day 1 and 1.4 mg/m2 of topotecan on Days 1–3. There was one complete response and one partial response in patients with nasopharyngeal carcinoma and one partial response in a patient with small cell lung carcinoma (SCLC). The response durations were 24 weeks, 29 weeks, and ≥ 244 weeks, respectively. At the time of last follow‐up, both patients with nasopharyngeal carcinoma were still alive at 241 weeks and 244 weeks, respectively.CONCLUSIONSThis trial demonstrated that a regimen of docetaxel and topotecan with G‐CSF support was generally well tolerated and had promising activity in patients with nasopharyngeal and SCLC. Cancer 2004. © 2004 American Cancer Society.

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Topotecan versus paclitaxel for the treatment of recurrent epithelial ovarian cancer.

Abstract: Topotecan has efficacy at least equivalent to paclitaxel manifested by the higher response rate and significantly longer time to progression.

Cited by 615 publications

References 14 publications

A phase II study of sequential carboplatin, paclitaxel and topotecan in patients with previously untreated advanced ovarian cancer

A phase II study of sequential carboplatin, paclitaxel and topotecan in patients with previously untreated advanced ovarian cancer

Thymidine kinase gene therapy with concomitant topotecan chemotherapy for recurrent ovarian cancer

Phase I evaluation of docetaxel and topotecan for patients with advanced solid tumors

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