Phase II study of gemcitabine in previously platinum-treated ovarian cancer patients

Lund, Birthe; Hansen, Ole Paaske; Neijt, J.P.; Theilade, Karen; Hansen, Mogens

doi:10.1097/00001813-199512006-00010

Cited by 56 publications

(27 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Liposomal doxorubicin also exhibits other common adverse events that, although not life threatening, have severe quality-of-life implications (Table 1) [3,28,31,[38][39][40][41]. Mild to moderate alopecia is reported in approximately 16% of patients.…”

Section: Duntonmentioning

confidence: 99%

“…Myelosuppression is the primary dose-limiting toxicity of gemcitabine, especially when administered in conjunction with cisplatin or carboplatin therapy because of overlapping toxicity. Frequent monitoring of hematologic parameters and dose modifications is needed to manage the anemia, leukopenia, and thrombocytopenia associated with gemcitabine therapy [39]. Thrombocytopenia is usually most pronounced at higher doses [45].…”

Section: Gemcitabinementioning

confidence: 99%

“…The dose-limiting effect for topotecan is short-term, noncumulative neutropenia, and dosedependent thrombocytopenia and anemia are common. The reported incidence rates for these acute effects are summarized in Table 1 [3,28,31,[38][39][40][41]. A number of studies have shown that multiple factors may affect the severity of myelosuppression in response to topotecan therapy.…”

Section: Topotecanmentioning

confidence: 99%

See 2 more Smart Citations

Management of Treatment-Related Toxicity in Advanced Ovarian Cancer

Dunton

2002

The Oncologist

View full text Add to dashboard Cite

Recognition of recurrent ovarian cancer as a disease with significant secondary responses and remissions has led to an increase in the need for oncologists to plan for the long-term therapy of patients. However, many of the currently available front-line and salvage agents used in advanced ovarian cancer are associated with cumulative and/or irreversible toxicities that pose challenges in longterm planning. The irreversible effects associated with some of these therapies may render patients less tolerant to subsequent treatments and lead to a cycle of diminishing treatment options with each remission and disease relapse. Additionally, the potential for patients to experience cumulative toxicity must be carefully weighed against the goals of prolonging the disease-free interval and improving patient quality of life. A number of agents are available in the treatment armamentarium (platinum, paclitaxel, gemcitabine, etoposide, liposomal doxorubicin, and topotecan), many, but not all of which are associated with cumulative toxicity. For instance, cumulative neurotoxicity associated with cisplatin as first-line therapy may diminish the option for retreatment with platinum at first relapse. In contrast, the main toxicity associated with topotecan is noncumulative, manageable myelosuppression. In this review, the major toxicities associated with the predominant chemotherapy agents used in advanced ovarian cancer are discussed along with selected management approaches in the context of long-term treatment planning and sequencing.

show abstract

Section: Duntonmentioning

confidence: 99%

Section: Gemcitabinementioning

confidence: 99%

Section: Topotecanmentioning

confidence: 99%

See 1 more Smart Citation

Management of Treatment-Related Toxicity in Advanced Ovarian Cancer

Dunton

2002

The Oncologist

View full text Add to dashboard Cite

show abstract

“…Indeed, severe and/or cumulative toxicity may conspire to limit the dose and schedule of active agents or, alternatively, may lead to permanent discontinuation of therapy. The main toxicities, including potential cumulative toxicities for agents active in recurrent ovarian cancer, are summarized in Table 2 (19,(22)(23)(24)(25)(26)(27). With few exceptions, agents used in advanced ovarian cancer are associated with cumulative toxicities that pose challenges to long-term treatment planning.…”

Section: Rationale Against Treatment To Progressionmentioning

confidence: 99%

Recurrent Ovarian Cancer

Herzog

2004

Clinical Cancer Research

137

View full text Add to dashboard Cite

Ovarian cancer is increasingly recognized as a chronic disease whose treatment is often characterized by administration of multiple, sequential active agents, each of which may or may not be accompanied by a tumor response. Despite the large proportion of patients who relapse and undergo longer-term treatment, the question of optimal treatment duration has not been fully addressed to date. For patients who progress on therapy, the answer is straightforward: they are switched to another active agent, presumably having a different mechanism of action from previous therapies with, ideally, limited overlapping toxicities. However, for patients who remain in partial response or who have stable disease, the answer is less apparent and less clear. The majority of oncologists believe that treatment beyond 6 cycles of a given therapy does not provide any additional benefit to patients. There are some data to support that treatment strategy. However, with the advent of new, less toxic agents, treatment to progression should be further explored. Agents that are potentially well suited for extended treatment intervals may include such properties as absence of cumulative toxicity, non-cross-resistance, positive benefit on quality of life, and convenient schedule. A number of active agents in ovarian cancer (platinum, paclitaxel, topotecan, liposomal doxorubicin, docetaxel, gemcitabine, and etoposide) will be reviewed in the context of what is known about cumulative toxicity, potential adverse effects on patients' quality of life, and evidence addressing the potential benefits of longer-term treatment.

show abstract

“…Salvage therapy in these settings is non-platinum and non-taxane drug. The responses of refractory or platinumresistant EOC to salvage chemotherapy are generally low and range from 10-20% (Lund et al, 1994;Rose et al, 1998;Gordon et al, 2001;Markman et al, 2002). Although the combined chemotherapy can yield higher responses, a survival improvement cannot be demonstrated (Bookman et al, 2009).…”

Section: Introductionmentioning

confidence: 99%