High-dose chemotherapy with autologous bone marrow transplantation in patients with refractory ovarian cancer

Phase I study of high-dose topotecan with haematopoietic stem cell support in the treatment of ovarian carcinomas: the ITOV 01 protocol

“…An additional difficulty encountered in interpreting the results is that the response is rarely surgically confirmed. [13][14][15][16][17][18][19][20][21][22][23] Nevertheless, some points are worth emphasizing: the achievement of high response rates, including responses in refractory tumours (although the duration of response is rarely prolonged) and the substantial decrease in morbidity and mortality achieved by the use of AHSCT and G-CSF support.…”

High-dose busulfan, melphalan and thiotepa followed by autologous peripheral blood stem cell (PBSC) rescue in patients with advanced stage III/IV ovarian cancer

“…[5][6][7][8][9][10][11][12][13][14] Patients treated had usually failed at least two prior regimens and had developed progressive disease either during or within 6 months of achieving a remission with platinum therapy. Although initial response rates of 55-75% have been reported, remission durations were consistently short-lived, usually only 5-7 months.…”

Phase II trial of high-dose intravenous doxorubicin, etoposide, and cyclophosphamide with autologous stem cell support in patients with residual or responding recurrent ovarian cancer

“…9,24 Retrospective and prospective non-randomized clinical trials of high-dose chemotherapy in epithelial ovarian cancer have confirmed high response rates and pathologic complete responses in chemotherapy-resistant patients. Furthermore, early reports of survival curves suggesting a plateau in progression-free and overall-survival at 24-48 months following treatment 6,7 have been confirmed in more recent publications of Stiff et al, 25 Legros et al 26 and Shinozuka et al 27 Prognostic factors have been examined by Stiff et al 25 They have shown that age, tumor bulk at the time of transplant, and platinum sensitivity, are predictive of longerterm survivals. Recent data from the European Intergroup (GINECO) study suggests a statistically significant median disease-free survival for patients receiving consolidation high-dose chemotherapy compared to patients receiving conventional-dose chemotherapy.…”

“…5 The use of this approach in patients with residual or recurrent disease has resulted in long-term disease-free survivals of 15-25% in multiple phase II trials of high-dose chemotherapy, with plateaus in survival curves appearing at approximately the 3-year post-treatment time point. 6,7 Multiple combinations of chemotherapeutic agents have been utilized as preparative regimens including platinum and non-platinum-based designs. Dottino et al 8 examined the effectiveness of etoposide in combination with cisplatin in previously treated patients and described a threshhold dose for etoposide, suggesting a dose-response relationship.…”

“…Dottino et al 8 examined the effectiveness of etoposide in combination with cisplatin in previously treated patients and described a threshhold dose for etoposide, suggesting a dose-response relationship. Mulder et al 6 reported complete responses in six of eight patients with microscopic or Ͻ2 cm residual disease in patients treated with a combination of a dose-intense etoposide/cyclophosphamide combination. Jacobs et al 9 have analyzed the effect of dose intensity on survival in previously untreated ovarian cancer patients.…”