Outcomes with Single Agent LIPO-DOX in Platinum-Resistant Ovarian and Fallopian Tube Cancers and Primary Peritoneal Adenocarcinoma - Chiang Mai University Hospital Experience

Abstract

Background: Single pegylated liposomal doxorubicin (PLD) is commonly used as a salvage treatment in platinum-resistant ovarian cancer, fallopian tube cancer and primary peritoneal adenocarcinoma (PPA) with a satisfactory outcome. However, the data for second generation PLD administered in this setting are still limited. We conducted a retrospective study to evaluate the outcome of patients who received single-agent second generation PLD (LIPO-DOX) after the development of clinical platinum resistance. The study period was between March 2008 and March 2013. LIPO-DOX was administered intravenously 40 mg/m 2 every 28 days until disease progression, but for not more than six cycles. The response rate was evaluated using the Gynecologic Cancer Intergroup (GCIG) criteria while the toxicity was evaluated according to WHO criteria. Twenty-nine patients met the inclusion criteria in the study period with an overall response rate of 13.8%. The median progression free survival and overall survival were three and eleven months, respectively. With the total of 96 cycles of chemotherapy, the patients developed grades 3 and 4 hematologic toxicity as follows: anemia, 0%, leukopenia, 9.6%, neutropenia, 32.3% and thrombocytopenia, 0%. In conclusion, the single agent second generation PLD demonstrated modest efficacy in patients with platinum-resistant ovarian cancer, fallopian tube cancer and PPA without serious toxicity.

Stereotactic Body Radiation Therapy in Oligometastatic Ovarian Cancer: A Promising Therapeutic Approach

“…22,23 In metastatic ovarian cancer, treatment options have been historically limited to further lines of chemotherapy, with limited benefits in terms of survival and substantial impact on patient's quality of life. 24,25 In the past, radiotherapy for ovarian cancer found a role only in the palliative setting to relieve symptoms of large metastases, with the exception of isolated experiences of whole abdominopelvic radiotherapy correlated with high rates of toxicity. 26Y28 Few experiences are reported in literature, regarding the use of SBRTin oligometastatic gynecological malignancies.…”

Early Activation of Apoptosis and Caspase-independent Cell Death Plays an Important Role in Mediating the Cytotoxic and Genotoxic Effects of WP 631 in Ovarian Cancer Cells

“…Doxorubicin (1 st generation of anthracyclines) exhibits a well-established activity in gynecologic malignancies, however, its clinical application is limited due to cumulative, dose-dependent cardiotoxicity, myelosuppression or kidneys failure (Shirinbayan and Roshan, 2012;Carvalho et al, 2013). Additionally, pegylated liposomal doxorubicin (an anthracycline of the second generation) demonstrated modest efficacy in patients with platinum-resistant ovarian cancer (Suprasert et al, 2014). One of the promising alternatives to the current strategy of ovarian cancer treatment is the bisintercalating anthracycline analog -WP 631.…”

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

“…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).…”