Outcome of Single Agent Generic Gemcitabine in Platinum-Resistant Ovarian Cancer, Fallopian Tube Cancer and Primary Peritoneal Adenocarcinoma

Suprasert, Prapaporn; Cheewakriangkrai, Chalong; Manopunya, Manatsawee

doi:10.7314/apjcp.2012.13.2.517

Cited by 10 publications

(6 citation statements)

References 10 publications

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“…Upon the approval of the use of GEM in the treatment of ovarian cancers in Europe, USA, and other countries in recent years, GEM is becoming a promising new drug in the treatment of ovarian cancers. Recently GEM has been shown to be effective in the treatment of ovarian cancers especially in the platinum resistant subclass, either used alone or in combination with other drugs [1], [40], [44], [45], [46].…”

Section: Introductionmentioning

confidence: 99%

Gemcitabine Eliminates Double Minute Chromosomes from Human Ovarian Cancer Cells

Zhao

Quan

et al. 2013

PLoS ONE

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Double minute chromosomes are cytogenetic manifestations of gene amplification frequently seen in cancer cells. Genes amplified on double minute chromosomes include oncogenes and multi-drug resistant genes. These genes encode proteins which contribute to cancer formation, cancer progression, and development of resistance to drugs used in cancer treatment. Elimination of double minute chromosomes, and therefore genes amplified on them, is an effective way to decrease the malignancy of cancer cells. We investigated the effectiveness of a cancer drug, gemcitabine, on the loss of double minute chromosomes from the ovarian cancer cell line UACC-1598. Gemcitabine is able to decrease the number of double minute chromosomes in cells at a 7500X lower concentration than the commonly used cancer drug hydroxyurea. Amplified genes present on the double minute chromosomes are decreased at the DNA level upon gemcitabine treatment. Gemcitabine, even at a low nanomolar concentration, is able to cause DNA damage. The selective incorporation of double minutes chromatin and γ-H2AX signals into micronuclei provides a strong link between DNA damage and the loss of double minute chromosomes from gemcitabine treated cells. Cells treated with gemcitabine also showed decreased cell growth, colony formation, and invasion. Together, our results suggest that gemcitabine is effective in decreasing double minute chromosomes and this affects the biology of ovarian cancer cells.

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Section: Introductionmentioning

confidence: 99%

Gemcitabine Eliminates Double Minute Chromosomes from Human Ovarian Cancer Cells

Zhao

Quan

et al. 2013

PLoS ONE

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“…This might be from the small number of our studied patients in these groups. However, we also published the outcome of generic gemcitabine and PLD (Lipodox ® ) in the setting of salvage treatment with the response rate of 12.1-13.8 % and median overall survival at ten and eleven months, respectively (Suprasert et al, 2012;Suprasert et al, 2014). Currently, the adding of Bevacizumab, an anti-angiogenesis drug, to standard chemotherapy provided significant improvement in the progression-free survival when compared to chemotherapy alone (Gonzalez-Martin, 2013).…”

Section: Discussionmentioning

confidence: 99%

Survival Outcomes of Recurrent Epithelial Ovarian Cancer: Experience from a Thailand Northern Tertiary Care Center

Jansaka

Suprasert²

2015

Asian Pacific Journal of Cancer Prevention

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To assess survival outcomes in a retrospective study, recurrent epithelial ovarian cancer patients were divided into three groups according to the platinum free interval as follows: platinum refractory that included the patients with tumor progression during treatment; platinum resistant and platinum sensitive that included the patients with tumor progression less than or more than six months, respectively. Clinical data for tumor progression in epithelial ovarian cancer patients treated at Chiang Mai University Hospital between January, 2006 and December, 2010 were reviewed. Thirty-nine patients were in the platinum refractory group while 27 were in the platinum resistant group and 75 in the platinum sensitive group. The mean age, the parity, the administration of neoadjuvant chemotherapy and the serous type did not significantly different across groups while the mean total number of chemotherapy regimens, the early stage patients, the patients with complete surgery and the surviving patients were significant more frequent in the platinum sensitive group. Regarding subsequent treatment after tumor recurrence, 87.2% underwent chemotherapy. With the median follow up time at 29 months, the median overall survival rates were 20 months, 14 months and 42 months in platinum refractory, platinum resistant and platinum sensitive groups, respectively (p<0.001). In addition, when the platinum sensitive patients developed the next episode of tumor progression, the median progression free interval time was only three to four months. In conclusion, the outcomes for platinum refractory the and platinum resistant groups was poorer than the platinum sensitive group. However, subsequent progression in the platinum sensitive group was also associated with a poor outcome.

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“…There have not yet been any well-designed studies on gemcitabine, PLD, and topotecan in Thailand, therefore the present study used the clinical data from review literature. In the study of Suprasert et al (2012), it was found that response rate of generic gemcitabine in patients with recurrent epithelial ovarian cancer, fallopian tube cancer and primary peritoneal adenocarcinoma was 12.1% while the median progression free survival was 2 months and median overall survival was 10 months. From the study it could be concluded that generic gemcitabine seemed to have comparable outcomes with original gemcitabine in treating platinum-resistant epithelial ovarian cancer with minimal toxicity especially in patients who received the treatment as a second-line drug after resistance to platinum-based chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Cost Effectiveness Analysis of Different Management Strategies between Best Supportive Care and Second-line Chemotherapy for Platinum-resistant or Refractory Ovarian Cancer

Luealon

Khempech²,

Vasuratna³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Asian Pac J Cancer Prev, 17 (2), 799-805 IntroductionOvarian cancer is one of the most common causes of death from gynecologic cancer in the world. Most cases are diagnosed in advanced stage and there is still no effective AbstractBackground: There is no standard treatment for patients with platinum-resistant or refractory epithelial ovarian cancer. Single agent chemotherapies have evidence of more efficacy and less toxicity than combination therapy. Most are very expensive, with appreciable toxicity and minimal survival. Since it is difficult to make comparison between outcomes, economic analysis of single-agent chemotherapy regimens and best supportive care may help to make decisions about an appropriate management for the affected patients. Objective: To evaluate the cost effectiveness of second-line chemotherapy compared with best supportive care for patients with platinum-resistant or refractory epithelial ovarian cancer. Materials and Methods: A Markov model was used to estimate the effectiveness and total costs associated with treatments. The hypothetical patient population comprised women aged 55 with platinum-resistant or refractory epithelial ovarian cancer. Four types of alternative treatment options were evaluated: 1) gemcitabine followed by BSC; 2) pegylated liposomal doxorubicin (PLD) followed by BSC; 3) gemcitabine followed by topotecan; and 4) PLD followed by topotecan. Baseline comparator of alternative treatments was BSC. Time horizon of the analysis was 2 years. Health care provider perspective and 3% discount rate were used to determine the costs of medical treatment in this study. Quality-adjusted life-years (QALY) were used to measure the treatment effectiveness. Treatment effectiveness data were derived from the literature. Costs were calculated from unit cost treatment of epithelial ovarian cancer patients at various stages of disease in King Chulalongkorn Memorial Hospital (KCMH) in the year 2011. Parameter uncertainty was tested in probabilistic sensitivity analysis by using Monte Carlo simulation. One-way sensitivity analysis was used to explore each variable's impact on the uncertainty of the results. Results: Approximated life expectancy of best supportive care was 0.182 years and its total cost was 26,862 Baht. All four alternative treatments increased life expectancy. Life expectancy of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 0.510, 0.513, 0.566, and 0.570 years, respectively. The total cost of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 113,000, 124,302, 139,788 and 151,135 Baht, respectively. PLD followed by topotecan had the highest expected quality-adjusted life-years but was the most expensive of all the above strategies. The incremental cost-effectiveness ratios (ICER) of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 344,643, 385,322, 385,856, and 420,299...

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Outcome of Single Agent Generic Gemcitabine in Platinum-Resistant Ovarian Cancer, Fallopian Tube Cancer and Primary Peritoneal Adenocarcinoma

Cited by 10 publications

References 10 publications

Gemcitabine Eliminates Double Minute Chromosomes from Human Ovarian Cancer Cells

Gemcitabine Eliminates Double Minute Chromosomes from Human Ovarian Cancer Cells

Survival Outcomes of Recurrent Epithelial Ovarian Cancer: Experience from a Thailand Northern Tertiary Care Center

Cost Effectiveness Analysis of Different Management Strategies between Best Supportive Care and Second-line Chemotherapy for Platinum-resistant or Refractory Ovarian Cancer

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