联合PEG脂质体阿霉素及脱氧胞嘧啶核苷对早先行铂类-紫杉烷化疗致铂类耐药卵巢癌患者有效且毒性可耐受:Ⅱ期奥地利AGO研究

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Objectives.:Platinum resistance is a significant problem in patients with ovarian cancer. The aim of this phase II study was to define the response rates,the progression-free survival and the toxicity profile of the combination of PEG liposomal doxorubicin (L-DXR) and gemcitabine (GEM). Material and methods.:Thirty one patients with histologically confirmed platinum-refractory or-resistant epithelial ovarian cancer were scheduled to receive 6 cycles of L-DXR 30 mg/m2 on day 1 as well as GEM 650 mg/m2 on days 1 and 8 every 28 days. Results.:The median number of chemotherapy cycles given was 4. The mean dose intensity for L-DXR and GEM on day 1 was 96%and 97%,respectively. The mean dose intensity for GEM on day 8 was 93%. The overall response rate was 33%(10 of 30 evaluable patients; 20%complete responses). The median progression-free survival was 3.8 months,and the median overall survival was 15.8 months,respectively. Toxicity was acceptable. One quarter of patients developed grade 3 or 4 neutropenia,but none developed febrile neutropenia. Palmoplantar erythrodysesthesia (PPE) grades 2 and 3 occurred in 13%and 3%only,respectively,and no grade 4 PPE was observed. Grades 1 to 3 stomatitis was found in 58%of patients (10%grade 3). Conclusion.:The combination of L-DXR and GEM is an active and acceptably tolerated option in the treatment of patients with platinum-resistant and-refractory ovarian cancer. Dose reductions seem advisable in the case of ≥grade 2 stomatitis and/or PPE ≥grade 2. The aim of this phase II study was to define the response rates, the progression-free survival and the toxicity profile of the combination of PEG liposomal doxorubicin (L-DXR) and gemcitabine (GEM). Material and methods.: Three patients with histologically confirmed platinum-refractory or-resistant epithelial ovarian cancer were scheduled to receive 6 cycles of L-DXR 30 mg / m2 on day 1 as GEM 650 mg / m2 on days 1 and 8 every 28 days. Results.:The median dose of chemotherapy cycles given was 4. The mean dose intensity for L-DXR and GEM on days 1 was 96% and 97%, respectively. The mean dose intensity for GEM on day 8 was 93%. The overall response rate was 33% (10 of 30 evaluable patients; 20% complete responses). The median progression-free survival was 3.8 months, and the median overall survival was 15.8 months, respectively. Toxicity was acceptable. One quarter of patients developed grade 3 or Grades 1 to 3 stomatitis was found in 58% of patients (4) neutropenia, but none developed febrile neutropenia. Palmoplantar erythrodysesthesia (PPE) grades 2 and 3 occurred in 13% and 3% only, respectively, and no grade 4 PPE was observed. 10% grade 3). Conclusion:: The combination of L-DXR and GEM is an active and acceptably tolerated option in the treatment of patients with platinum-resistant and-refractory ovarian cancer. Dose reductions seem advisable in the case of ≥ grade 2 stomatitis and / or PPE ≥ grade 2.
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