Psychological Sequelae and Alopecia Among Women with Cancer

McGarvey, Elizabeth L.; Baum, Lora D.; Pinkerton, Relana C.; Rogers, Laura M.

doi:10.1111/j.1523-5394.2001.96007.pp.x

Cited by 80 publications

(58 citation statements)

References 46 publications

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“…The relatively low rate of alopecia with carboplatin/patupilone is an important advantage to this combination, particularly in the treatment of women. Alopecia has been cited as the most disturbing side effect anticipated by almost 60% of women preparing for chemotherapy and is a risk factor for the discontinuation of therapy (28). Treatment-related neuropathy, a significant side effect of the taxanes, was uncommon.…”

Section: Resultsmentioning

confidence: 99%

A Phase Ib and Pharmacokinetic Trial of Patupilone Combined with Carboplatin in Patients with Advanced Cancer

Förster

Kaye

Oza

et al. 2007

Clinical Cancer Research

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Purpose: Patupilone is a microtubule-targeting chemotherapeutic agent with clinical activity in a broad range of taxane-sensitive/resistant tumor types. The present phase Ib study examined the safety/tolerability and pharmacokinetics of patupilone in combination with carboplatin in patients with advanced solid tumors. Experimental Design: Patients with advanced cancer received patupilone via a 5-to 10-min i.v. infusion at doses of 3.6 to 6.0 mg/m 2 q3w, immediately followed by carboplatin area under the curve (AUC) 5 or 6 mg/mL/min. Results: Of the 37 patients enrolled, the majority previously received taxanes (81%) and/or platinum-containing drugs (97.3%). The maximum tolerated dose (MTD) of patupilone with carboplatin AUC 6 was 4.8 mg/m 2 ; additional patients were enrolled to consolidate experience at this dose. Of the 22 patients who received the MTD, the most common nonhematologic adverse events were fatigue in six (27.3%) and diarrhea, nausea, vomiting, abdominal pain, and neuropathy in one each (4.5%; all grade 3); hematologic toxicities included two patients (9.1%) with grade 3 neutropenia. The pharmacokinetics of patupilone were similar to those in a previous study of patupilone monotherapy. Of the 26 patients with recurrent platinum-sensitive ovarian cancer, tumor response was assessable by response evaluation criteria in solid tumors in 17; 1 patient (6%) achieved a complete response, and 10 (59%) achieved a partial response. Conclusions: The combination of patupilone 4.8 mg/m 2 /carboplatin AUC 6 was well tolerated and showed antitumor activity similar to established regimens in patients with recurrent platinumsensitive ovarian cancer. The optimal dose for this regimen is currently being further refined in phase II trials.

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Section: Resultsmentioning

confidence: 99%

A Phase Ib and Pharmacokinetic Trial of Patupilone Combined with Carboplatin in Patients with Advanced Cancer

Förster

Kaye

Oza

et al. 2007

Clinical Cancer Research

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“…This is consistent with the results reported in individual clinical trials. Although not necessarily life threatening, neuropathy can be dose limiting and functionally debilitating [31], and alopecia can have a significant impact on a patient's psychological wellbeing [32,33]. These side effects are important to consider when choosing therapeutic strategies.…”

Section: C؉pldmentioning

confidence: 99%

The Role of Pegylated Liposomal Doxorubicin in Ovarian Cancer: A Meta-Analysis of Randomized Clinical Trials

et al. 2013

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Background. Recent studies suggest that carboplatin with pegylated liposomal doxorubicin (CϩPLD) is as efficacious as carboplatin with paclitaxel (CϩP) and possibly is more tolerable for ovarian cancer therapy. Pegylated liposomal doxorubicin(PLD)mayalsobeefficaciousandtolerableasmonotherapyin recurrent or platinum-resistant disease. We performed a metaanalysis of randomized trials in order to elucidate the role of PLD in ovarian cancer. Methods. We searched PubMed, Scopus, and ISI Web of Knowledge for studies comparing CϩPLD with CϩP and comparing PLD with another monotherapy. Summary hazard ratios (HRs) and relative risks with their corresponding 95% confidence intervals (CIs) were calculated using a fixed-effects model. Results. Three trials were included in the doublet regimen analysis, and five trials were included in the monotherapy regimen analysis. CϩPLD provided superior progression-free survival (PFS) (HR, 0.87; 95% CI, 0.78 -0.96) and similar overall survival (OS; HR, 0.95; 95% CI, 0.84 -1.07) compared with CϩP. There was no evidence of improved tolerability: CϩPLD had more gastrointestinal toxicity, anemia, thrombocytopenia, cutaneous toxicity, and mucositis/stomatitis, although there was less neutropenia, neuropathy, and alopecia. PLD monotherapy had similar PFS (HR, 0.99; 95% CI, 0.89 -1.11) and OS (HR, 0.99; 95% CI, 0.88 -1.11) to other monotherapies, but it was more tolerable. There was less neutropenia, anemia, thrombocytopenia, and gastrointestinal toxicity, although cutaneous toxicity was increased. Conclusion. CϩPLD had better PFS and similar OS compared with CϩP and had a very different toxicity profile. Therapy selection could be based on patient risks for side effects. PLD is as efficacious as other monotherapies and is more tolerable. The Oncologist 2013;18:1022-1031 Implications for Practice: Carboplatin with paclitaxel (CϩP) has been the standard first-line chemotherapy regimen for ovarian cancer patients; however, two large randomized trials of carboplatin and pegylated liposomal doxorubicin (CϩPLD) versus CϩP suggest that CϩPLD is as efficacious as CϩP and possibly is more tolerable. The results of our analysis showed that CϩPLD has better progression-free survival than CϩP and similar overall survival; however, we did not find CϩPLD to be more tolerable than CϩP. The toxicity profiles were very different, and therapy selection could reasonably be based on individual patient risks of side effects. Pegylated liposomal doxorubicin (PLD) is also a treatment option for recurrent or platinum-resistant ovarian cancer, but there is no clear distinction among any of the monotherapy options in this setting. The results of our analysis showed that PLD is as efficacious as other monotherapies and is more tolerable. Consequently, it may be the preferred agent in the palliative setting. INTRODUCTIONOvarian cancer is the leading cause of death from gynecologic malignancies in the United States [1]. Standard first-line treatment includes surgical debulking and platinum-based chemotherapy, us...

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“…12,13 In one study, 8% women were found to be at risk of avoiding treatment secondary to fear of baldness. 14 Irreversible/permanent alopecia has been described but its exact incidence remains unknown 4-9 and its mechanism is not well studied. It is mostly reported after high-dose Bucontaining regimens.…”

Section: Discussionmentioning

confidence: 99%

Six cases of permanent alopecia after various conditioning regimens commonly used in hematopoietic stem cell transplantation

Machado

Moreb

Khan

2007

Bone Marrow Transplant

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Alopecia, a side effect of chemotherapy, is usually temporary and reversible. Irreversible alopecia has been reported after high-dose chemotherapy (HDC) and hematopoietic stem cell transplantation (HSCT) especially related to BuCy containing conditioning regimens; however, the overall incidence is not known. We conducted a retrospective study to identify patients with chemotherapy-induced permanent alopecia after HSCT. We describe six such patients, two males and four females, among 760 patients transplanted between 1997 and 2004. Median age was 45 years (range, 37-65). There were three Caucasians and three African-Americans. Median follow-up was 30 months. Conditioning regimens included BuCy, Bu/Cy and etoposide (VP16) (one of these patients received second autograft after Cy and TBI) and CyVP16 and TBI. Our data show that permanent alopecia is a significant long-term side effect of HSCT and can be seen across the spectrum of diseases and transplant types and with non-busulfan containing regimens. We have observed that patients usually accept permanent alopecia as the price for the cure and therefore true incidence of permanent alopecia may be underestimated. Our findings may also have medico legal and psychosocial implications that need to be taken into consideration when consenting patients for HSCT.

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Psychological Sequelae and Alopecia Among Women with Cancer

Cited by 80 publications

References 46 publications

A Phase Ib and Pharmacokinetic Trial of Patupilone Combined with Carboplatin in Patients with Advanced Cancer

A Phase Ib and Pharmacokinetic Trial of Patupilone Combined with Carboplatin in Patients with Advanced Cancer

The Role of Pegylated Liposomal Doxorubicin in Ovarian Cancer: A Meta-Analysis of Randomized Clinical Trials

Six cases of permanent alopecia after various conditioning regimens commonly used in hematopoietic stem cell transplantation

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