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International Journal of Clinical Oncology

, Volume 23, Issue 4, pp 698–706 | Cite as

Efficacy of weekly administration of paclitaxel and carboplatin for advanced ovarian cancer patients with poor performance status

  • Hisamitsu Takaya
  • Hidekatsu Nakai
  • Kosuke Murakami
  • Takako Tobiume
  • Ayako Suzuki
  • Masaki Mandai
  • Noriomi Matsumura
Original Article

Abstract

Objective

The aim of this study was to reveal the efficacy of weekly administration of paclitaxel and carboplatin for advanced ovarian cancer patients with poor performance status (PS).

Methods

FIGO stage III/IV ovarian cancer or fallopian tube cancer patients who underwent interval debulking surgery (IDS) followed by neoadjuvant chemotherapy (NAC) were analyzed retrospectively. Patients were divided into two groups based on NAC: weekly paclitaxel and carboplatin (W-TC) and 3 weeks of paclitaxel and carboplatin (TW-TC). Toxicity, efficacy of NAC, surgery outcome, and prognosis were assessed by comparing the two groups.

Results

Twenty patients treated with W-TC and 18 patients treated with TW-TC were analyzed. All of the W-TC patients were poor PS (PS ≥ 2), and all of the TW-TC patients were good PS (PS ≤ 1). The overall clinical response rates were 70% in W-TC and 83.4% in TW-TC. In the W-TC group, Grade 3/4 anemia and thrombocytopenia and greater than grade 2 neuropathy were significantly reduced compared to TW-TC patients. A frequency of treatment delay greater than 7 and 14 days, G-CSF support, blood transfusion, and dose reduction or regimen change were also significantly reduced in the W-TC group. The rate of IDS, optimal debulking surgery, complications during operation, and blood transfusion were similar between the W-TC and TW-TC groups. Progression-free survival and overall survival were also similar between the two groups.

Conclusion

Our study suggested that NAC with W-TC for poor PS patients with non-treated ovarian cancer reduced the toxicity of chemotherapy and had the same efficacy as TW-TC.

Keywords

Ovarian neoplasms Neoadjuvant therapy Antineoplastic combined chemotherapy protocols Patient acuity 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Sopik V, Iqbal J, Rosen B et al (2015) Why have ovarian cancer mortality rates declined? Part I. Incidence. Gynecol Oncol 138:741–749CrossRefPubMedGoogle Scholar
  2. 2.
    Yamagami W, Aoki D (2015) Annual report of the Committee on Gynecologic Oncology, the Japan Society of Obstetrics and Gynecology. J Obstet Gynaecol Res 41:167–177CrossRefPubMedGoogle Scholar
  3. 3.
    van der Burg MEL, van Lent M, Buyse M et al (1995) The effect of debulking surgery after induction chemotherapy on the prognosis in advanced epithelial ovarian cancer. N Engl J Med 332:629–634CrossRefPubMedGoogle Scholar
  4. 4.
    Bristow RE, Tomacruz RS, Armstrong DK et al (2002) Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 20:1248–1259CrossRefPubMedGoogle Scholar
  5. 5.
    Kemp Z, Ledermann J (2013) Update on first-line treatment of advanced ovarian carcinoma. Int J Womens Health 5:45–51PubMedPubMedCentralGoogle Scholar
  6. 6.
    Sopik V, Iqbal J, Rosen B et al (2015) Why have ovarian cancer mortality rates declined? Part II. Case-fatality. Gynecol Oncol 138:750–756CrossRefPubMedGoogle Scholar
  7. 7.
    Langstraat C, Cliby WA (2013) Considerations in the surgical management of ovarian cancer in the elderly. Curr Treat Options Oncol 14:12–21CrossRefPubMedGoogle Scholar
  8. 8.
    Fleury AC, Kushnir CL, Giuntoli RL et al (2012) Upper abdominal cytoreduction and thoracoscopy for advanced epithelial ovarian cancer: unanswered questions and the impact on treatment. BJOG 119:202–206CrossRefPubMedGoogle Scholar
  9. 9.
    Vergote I, Tropé CG, Amant F et al (2010) Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med 363:943–953CrossRefPubMedGoogle Scholar
  10. 10.
    Kehoe S, Hook J, Nankivell M et al (2015) Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet 386:249–257CrossRefPubMedGoogle Scholar
  11. 11.
    Onda T, Kobayashi H, Nakanishi T et al (2009) Feasibility study of neoadjuvant chemotherapy followed by interval debulking surgery for stage III/IV ovarian, tubal, and peritoneal cancers: Japan Clinical Oncology Group Study JCOG0206. Gynecol Oncol 113:57–62CrossRefPubMedGoogle Scholar
  12. 12.
    Jørgensen TL, Teiblum S, Paludan M et al (2012) Significance of age and comorbidity on treatment modality, treatment adherence, and prognosis in elderly ovarian cancer patients. Gynecol Oncol 127:367–374CrossRefPubMedGoogle Scholar
  13. 13.
    Liutkauskiene S, Janciauskiene R, Jureniene K et al (2015) Retrospective analysis of the impact of platinum dose reduction and chemotherapy delays on the outcomes of stage III ovarian cancer patients. BMC Cancer 15:105CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Sculier JP, Lafitte JJ, Paesmans M et al (2007) Chemotherapy improves low performance status lung cancer patients. Eur Respir J 30:1186–1192CrossRefPubMedGoogle Scholar
  15. 15.
    Spiro SG, Rudd RM, Souhami RL et al (2004) Chemotherapy versus supportive care in advanced non-small cell lung cancer: improved survival without detriment to quality of life. Thorax 59:828–836CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Seifert H, Georgiou A, Alexander H et al (2015) Poor performance status (PS) is an indication for an aggressive approach to neoadjuvant chemotherapy in patients with advanced epithelial ovarian cancer (EOC). Gynecol Oncol 139:216–220CrossRefPubMedGoogle Scholar
  17. 17.
    Wu CH, Yang CH, Lee JN et al (2001) Weekly and monthly regimens of paclitaxel and carboplatin in the management of advanced ovarian cancer. A preliminary report on side effects. Int J Gynecol cancer 11:295–299CrossRefPubMedGoogle Scholar
  18. 18.
    Saito K, Kikuchi Y, Fujii K et al (2006) Effect of paclitaxel on vascular endothelial growth factor (VEGF) and interleukin (IL)-8 in serum of patients with recurrent ovarian cancer: a comparison of weekly vs triweekly regimens. Target Oncol 1:86–89CrossRefGoogle Scholar
  19. 19.
    Rose PG, Smrekar M, Fusco N (2005) A phase II trial of weekly paclitaxel and every 3 weeks of carboplatin in potentially platinum-sensitive ovarian and peritoneal carcinoma. Gynecol Oncol 96:296–300CrossRefPubMedGoogle Scholar
  20. 20.
    Watanabe Y, Nakai H, Ueda H et al (2005) Evaluation of weekly low-dose paclitaxel and carboplatin treatment for patients with platinum-sensitive relapsed ovarian cancer. Gynecol Oncol 96:323–329CrossRefPubMedGoogle Scholar
  21. 21.
    Havrilesky LJ, Alvarez AA, Sayer RA et al (2003) Weekly low-dose carboplatin and paclitaxel in the treatment of recurrent ovarian and peritoneal cancer. Gynecol Oncol 88:51–57CrossRefPubMedGoogle Scholar
  22. 22.
    Pignata S, Scambia G, Katsaros D et al (2014) Carboplatin plus paclitaxel once a week versus every 3 weeks in patients with advanced ovarian cancer (MITO-7): a randomised, multicentre, open-label, phase 3 trial. Lancet Oncol 15:396–405CrossRefPubMedGoogle Scholar
  23. 23.
    Safra T, Menczer J, Bernstein RM et al (2009) Combined weekly carboplatin and paclitaxel as primary treatment of advanced epithelial ovarian carcinoma. Gynecol Oncol 114:215–218CrossRefPubMedGoogle Scholar
  24. 24.
    Safra T, Shamai S, Greenberg J et al (2014) Weekly carboplatin with paclitaxel compared to standard three-weekly treatment in advanced epithelial ovarian carcinoma—a retrospective study. Gynecol Oncol 132:18–22CrossRefPubMedGoogle Scholar
  25. 25.
    Pignata S, Breda E, Scambia G et al (2008) A phase II study of weekly carboplatin and paclitaxel as first-line treatment of elderly patients with advanced ovarian cancer. A Multicentre Italian Trial in Ovarian cancer (MITO-5) study. Crit Rev Oncol Hematol 66:229–236CrossRefPubMedGoogle Scholar
  26. 26.
    Sehouli J, Stengel D, Mustea A et al (2008) Weekly paclitaxel and carboplatin (PC-W) for patients with primary advanced ovarian cancer: results of a multicenter phase-II study of the NOGGO. Cancer Chemother Pharmacol 61:243–250CrossRefPubMedGoogle Scholar
  27. 27.
    Marsland TA, Garfield DH, Khan MM et al (2005) Sequential versus concurrent paclitaxel and carboplatin for the treatment of advanced non-small cell lung cancer in elderly patients and patients with poor performance status: results of two Phase II, multicenter trials. Lung cancer 47:111–120CrossRefPubMedGoogle Scholar
  28. 28.
    Huang T-C, Campbell TC (2012) Comparison of weekly versus every 3 weeks paclitaxel in the treatment of advanced solid tumors: a meta-analysis. Cancer Treat Rev 38:613–617CrossRefPubMedGoogle Scholar
  29. 29.
    Mauri D, Kamposioras K, Tsali L et al (2010) Overall survival benefit for weekly vs. three-weekly taxanes regimens in advanced breast cancer: a meta-analysis. Cancer Treat Rev 36:69–74CrossRefPubMedGoogle Scholar
  30. 30.
    Kanda Y (2013) Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant 48:452–458CrossRefPubMedGoogle Scholar
  31. 31.
    Katsumata N, Yasuda M, Isonishi S et al (2013) Long-term results of dose-dense paclitaxel and carboplatin versus conventional paclitaxel and carboplatin for treatment of advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer (JGOG 3016): a randomised, controlled, open-label trial. Lancet Oncol 14:1020–1026CrossRefPubMedGoogle Scholar
  32. 32.
    Ma BB, Hui EP, Mok TS (2010) Population-based differences in treatment outcome following anticancer drug therapies. Lancet Oncol 11:75–84CrossRefPubMedGoogle Scholar
  33. 33.
    Gonzalez-Martin A, Gladieff L, Tholander B et al (2013) Efficacy and safety results from OCTAVIA, a single-arm phase II study evaluating front-line bevacizumab, carboplatin and weekly paclitaxel for ovarian cancer. Eur J Cancer 49:3831–3838CrossRefPubMedGoogle Scholar

Copyright information

© Japan Society of Clinical Oncology 2018

Authors and Affiliations

  • Hisamitsu Takaya
    • 1
  • Hidekatsu Nakai
    • 1
  • Kosuke Murakami
    • 1
  • Takako Tobiume
    • 1
  • Ayako Suzuki
    • 1
  • Masaki Mandai
    • 2
  • Noriomi Matsumura
    • 1
  1. 1.Department of Obstetrics and GynecologyKindai University Faculty of MedicineOsaka-SayamaJapan
  2. 2.Department of Gynecology and ObstetricsKyoto UniversityKyotoJapan

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