Weekly Dose-Dense Paclitaxel and Triweekly Low-Dose Cisplatin: A Well-Tolerated and Effective Chemotherapeutic Regimen for First-Line Treatment of Advanced Ovarian, Fallopian Tube, and Primary Peritoneal Cancer

Abstract

A combination of cytoreductive surgery, either primary (PCS) or interval (ICS), and chemotherapy with a platinum-paclitaxel regimen is the well-accepted treatment for advanced-stage epithelial ovarian cancer (EOC), fallopian tube cancer (FTC), and primary peritoneal serous carcinoma (PPSC), but it is still uncertain whether a combination of dose-dense weekly paclitaxel and low-dose triweekly cisplatin is useful in the management of these patients. Therefore, we retrospectively evaluated the outcomes of women with advanced-stage EOC, FTC, and PPSC treated with PCS and subsequent dose-dense weekly paclitaxel (80 mg/m2) and low-dose triweekly cisplatin (20 mg/m2). Between January 2011 and December 2017, 32 women with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC–IV EOC, FTC, or PPSC were enrolled. Optimal PCS was achieved in 63.5% of patients. The mean and median progression-free survival was 36.5 and 27.0 months, respectively (95% confidence interval (CI): 26.8–46.2 and 11.3–42.7 months, respectively). The mean overall survival was 56.0 months (95% CI: 43.9–68.1 months), and the median overall survival could not be obtained. The most common all-grade adverse events (AEs) were anemia (96.9%), neutropenia (50%), peripheral neuropathy (28.1%), nausea and vomiting (34.4%), and thrombocytopenia (15.6%). These AEs were predominantly grade 1/2, and only a few patients were complicated by grade 3/4 neutropenia (21.9%) and anemia (6.3%). A multivariate analysis indicated that only suboptimal PCS was significantly correlated with a worse prognosis, resulting in an 11.6-fold increase in the odds of disease progression. In conclusion, our data suggest that dose-dense weekly paclitaxel (80 mg/m2) combined with low-dose triweekly cisplatin (20 mg/m2) is a potentially effective and highly tolerable front-line treatment in advanced EOC, FTC, and PPSC. Randomized trials comparing the outcome of this regimen to other standard therapies for FIGO stage IIIC–IV EOC, FTC, and PPSC are warranted.

Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer

“…The evaluation of image finding was based on Response Evaluation Criteria in Solid Tumors (RECIST), version 1.1 [127][128][129]. Criteria of progression or recurrence were based on findings of clinical symptoms or signs accompanied with image findings and tumor markers described elsewhere [41,130,131].…”

Collision carcinoma of endometrial adenocarcinoma and primary serous fallopian tube carcinoma: a case report

“…13 Previous studies have reported that platinum combined with other chemotherapeutic drugs, such as paclitaxel, for epithelial ovarian malignancies has become a general choice for postoperative fallopian tube cancer. 14,15 In this case, the endometrial adenocarcinoma was a lowgrade malignant tumor (grade I), which is mainly treated with surgery and postoperative chemoradiotherapy combined with hormone therapy, whereas the primary serous fallopian tube carcinoma is highly malignant, and is treated by surgery combined with chemotherapy. According to the treatment principle of multiple primary tumors, paclitaxel combined with platinum regimen was administered.…”

Microtubule-Interfering Drugs: Current and Future Roles in Epithelial Ovarian Cancer Treatment

“…Overall, randomized trials have suggested equivalent or improved efficacy with dose-dense regimens relative to conventionally dosed therapy, though toxicities are usually higher with the dose-dense regimens [ 25 , 26 , 27 , 28 , 29 , 30 ]. In some cases, dose-dense chemotherapy has been shown to be well tolerated and could be considered as frontline treatment in advanced ovarian cancer [ 31 , 32 ]. In patients with optimally resected stage III EOC, GOG 158 demonstrated that carboplatin with paclitaxel is less toxic, easier to administer, and not inferior to cisplatin plus paclitaxel [ 33 ].…”