High-dose versus low-dose cisplatin in combination with cyclophosphamide and epidoxorubicin in suboptimal ovarian cancer: a randomized study of the Gruppo Oncologico Nord-Ovest.

Conte, Pierfranco; Bruzzone, M; Carnino, F; Gadducci, Angiolo; Algeri, R; Bellini, A.; Boccardo, Francesco; Brunetti, I.; Catsafados, E; Chiara, S.; Foglia, G; Gallo, Luigi; Iskra, L; Mammoliti, Serafina; Parodi, Giancarlo; Ragni, Nicola; Rosso, Riccardo; Rugiati, S; Rubagotti, Alessandra

doi:10.1200/jco.1996.14.2.351

Cited by 85 publications

(34 citation statements)

References 12 publications

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“…Dose-intense treatment (higher mg per m 2 per unit of time) has been found to improve the survival of patients with breast cancer and other cancers (Hudis et al, 1999;Citron et al, 2003). But most clinical trials among patients with OC have failed to show a survival advantage of dose-intense regimens (McGuire et al, 1995(McGuire et al, , 1996Conte et al, 1996;Jakobsen et al, 1997;McGuire, 1997;Gore et al, 1998). For example, the Gynecologic Oncology Group (GOG) compared patients treated with eight cycles of standard dose cisplatin and cyclophosphamide to those receiving four cycles of high-dose therapy.…”

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confidence: 99%

Variability in chemotherapy delivery for elderly women with advanced stage ovarian cancer and its impact on survival

et al. 2008

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Given the survival benefits of adjuvant chemotherapy for advanced ovarian cancer (OC), we examined the associations of survival with the time interval from debulking surgery to initiation of chemotherapy and with the duration of chemotherapy. Among patients X65 years with stages III/IV OC diagnosed between 1991 and 2002 in the Surveillance, Epidemiology, and End Results-Medicare database, we developed regression models of predictors of the time interval from surgery to initiation of chemotherapy and of the total duration of chemotherapy. Survival was examined with Cox proportional hazards models. Among 2558 patients, 1712 (67%) initiated chemotherapy within 6 weeks of debulking surgery, while 846 (33%) began treatment 46 weeks. Older age, black race, being unmarried, and increased comorbidities were associated with delayed initiation of chemotherapy. Delay of chemotherapy was associated with an increase in mortality (hazard ratio (HR) ¼ 1.11; 95% CI, 1.0 -1.2). Among 1932 patients in the duration of treatment analysis, the 1218 (63%) treated for 3 -7 months had better survival than the 714 (37%) treated for p3 months (HR ¼ 0.84; 95% CI, 0.75 -0.94). This analysis represents one of the few studies describing treatment delivery and outcome in women with advanced OC. Delayed initiation and early discontinuation of chemotherapy were common and associated with increased mortality.

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confidence: 99%

Variability in chemotherapy delivery for elderly women with advanced stage ovarian cancer and its impact on survival

et al. 2008

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“…In advanced ovarian cancer the dose increase of each cycle with unchanged intervals did translate to an increase in sideeffects and limitation of dose intensification (Conte et al, 1996). However, acceleration of the same drugs has been shown to be feasible (Pronzato et al, 1996).…”

Section: Discussionmentioning

confidence: 99%

High-dose intensity cyclophosphamide, epidoxorubicin, vincristine and prednisone by shortened intervals and granulocyte colony-stimulating factor in non-Hodgkin's lymphoma: a phase II study

Pronzato¹,

Lionetto²,

Botto³

et al. 1998

Br J Cancer

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Summary Twenty patients with non-Hodgkin's lymphoma were treated with a combination of cyclophosphamide (750 mg m-2, day 1), epidoxorubicin (60 mg m-2, day 1), vincristine (1.4 mg m-2, day 1) and prednisone (100 mg m-2, days 1-5) every 14 days. Shortening of intervals was associated with the prophylactic employment of granulocyte colony-stimulating factor (G-CSF; specifically, filgrastim) administered at a dose of 300 gg subcutaneously from day 6 to day 11. The ratio between actually delivered dose intensity and planned dose intensity was 1.0 in 18 out the 20 patients. Toxicity was acceptable; response rate and survival are in the expected range. The present study demonstrated the feasibility of acceleration of chemotherapy cycles to obtain dose intensification in non-Hodgkin's lymphoma.

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“…Increasing platinum salt doses led to discordant data [7][8][9]. Increasing DI and/or total dose (TD), with either CDDP or CBDCA, enhances toxicity, while the therapeutic benefit remains slight [7,[10][11][12]. Reports of CBDCA dose escalation showed that with an alkylating agent, it could be safely delivered at AUC from 5 to 7 [11].…”

Section: Discussionmentioning

confidence: 99%

“…To answer the question as to whether the higher DI, the better results in AOC, cytotoxic drugs must be found whose dose can be increased safely to obtain such DI variations. Increasing platinum salt doses led to discordant data [7][8][9]. Increasing DI and/or total dose (TD), with either CDDP or CBDCA, enhances toxicity, while the therapeutic benefit remains slight [7,[10][11][12].…”

Section: Discussionmentioning

confidence: 99%

A Phase I/II Study of Dose-Escalated Ifosfamide plus Carboplatin Combination for Advanced Ovarian Carcinoma

Kurtz¹,

Deplanque²,

Duclos³

et al. 1999

Oncol Res Treat

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Background: Advanced ovarian cancer is often a fatal disease, despite good initial response to chemotherapy. Dose-intense schedules have been reported, but failed to demonstratesignificant breakthrough. This study evaluates high-dose ifosfamide (IFO) plus carboplatin (CBDCA) in advanced ovarian cancer. Patients and Methods:Twenty-eight patients entered this phase I/II study. All had diagnostic laparotomy and maximal debulking if possible. IFO and CBDCA were given every 3 weeks for 6 courses or less, if there was tumor progression. IFO levels ranged from 1.8 to 3 g/m²/day days 1–3, increasing by 0.3 g/m²/ day steps, and CBDCA was administered at AUC = 6. Results: An objective response (CR + PR) was obtained in 14/26 assessable patients (53.9%). The maximally tolerated dose was reached at the 2.7 g/m²/day IFO level. Treatment had to be terminated in 5 patients (3 with myelotoxicity, 1 with encephalopathy, and 1 refusal). Median disease-free survival time was 24.5 months, median survival time was 30 months. Conclusions: A combination of IFO 2.7 g/m²/day days 1–3 and CBDCA AUC = 6 can be administered safely in patients with advanced ovarian cancer. Data indicate that both response and disease-free survival rates do not differ from standard therapy.

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High-dose versus low-dose cisplatin in combination with cyclophosphamide and epidoxorubicin in suboptimal ovarian cancer: a randomized study of the Gruppo Oncologico Nord-Ovest.

Abstract: This study shows that doubling the dose-intensity and total dose of cisplatin in combination with epidoxorubicin and cyclophosphamide has significant toxic effects and does not improve clinical outcome in patients with suboptimal ovarian cancer.

Cited by 85 publications

References 12 publications

Variability in chemotherapy delivery for elderly women with advanced stage ovarian cancer and its impact on survival

Variability in chemotherapy delivery for elderly women with advanced stage ovarian cancer and its impact on survival

High-dose intensity cyclophosphamide, epidoxorubicin, vincristine and prednisone by shortened intervals and granulocyte colony-stimulating factor in non-Hodgkin's lymphoma: a phase II study

A Phase I/II Study of Dose-Escalated Ifosfamide plus Carboplatin Combination for Advanced Ovarian Carcinoma

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