Low dose (d1-5/7) oral etoposide regimen in intensively treated platinum-resistant epithelial ovarian cancer: The İzmir oncology group (IZOG) study

Low dose (d1-5/7) oral etoposide regimen in intensively treated platinum-resistant epithelial ovarian cancer: The İzmir oncology group (IZOG) study

Aim: Oral etoposide dosage is roughly 50-100 mg/m2 on days 1 to 21 every 28 days. However, dosage of 50 mg/day oral etoposidefor five days a week is not well published. The present study, aimed to evaluate the efficacy and toxicity profile of low dose oraletoposide regimen (50 mg/day on days 1 to 5 every week) in platinum-resistant epithelial ovarian cancer (EOC).Material and Methods: This study retrospectively evaluates patients with pathologically confirmed platinum-resistant EOC who wereunable to tolerate the standard oral etoposide regimen and were on low dose (d1-5/7) oral etoposide regimen in third line or beyondwithin the period between 2006 and 2014.Results: The overall response rate among 33 EOC patients was 15.1% while clinical benefit rate was 42.4% (stable disease in 27.3%and partial response in 15.1%). Median progression-free survival was 4 months (95% confidence interval [CI], 2.8–5.1 months) andmedian overall survival was 12 months (95% CI, 8.8–15.1 months).Conclusion: We concluded that low dose oral etoposide (50 mg/day, on days 1 to 5 every week) was effective and well tolerated forplatinum-resistant EOC.

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  • 1. Siegel R, Naishadham D, Jemal A. Cancer statistics. CA Cancer J Clin 2013; 63:11-30.
  • 2. Ben-Baruch G, Sivan E, Moran O, et al. Primary peritoneal serous papillary carcinoma: A study of 25 cases and comparison with Stage III-IV ovarian papillary serous carcinoma. Gynecol Oncol 1996;60: 393-6.
  • 3. Lacey JV, Sherman ME. Ovarian neoplasia. In: Robboy SL, Mutter GL, eds. Robboy’s Pathology of the Female Reproductive Tract. 2nd edition. Churchill Livingstone Elsevier Oxford 2009:601.
  • 4. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin 2011;61:69-90.
  • 5. Armstrong D. Relapsed ovarian cancer: challenges and management strategies for a chronic disease. Oncologis 2002;7:20-8.
  • 6. Thigpen T, duBois A, McAlpine J, et al. First-line therapy in ovarian cancer trials. Int J Gynecol Cancer 2011;21:756-62.
  • 7. Hoskins PJ, Le N. Identifying patients unlikely to benefit from further chemotherapy: A descriptive study of outcome at each relapse in ovarian cancer. Gynecologic Oncology 2005;97:862-9.
  • 8. Salom E, Almeida Z, Mirhashemi R. Management of recurrent ovarian cancer: evidence-based decisions. Curr Opin Oncol 2002;14:519-27.
  • 9. Satthapong D, Tangjitgamol S, Manusirivithaya S, et al. Chemotherapy in patients with recurrent or refractory epithelial ovarian cancer. J Med Assoc Thail 2007;90: 411-9.
  • 10. Ross W, Glisson B, Yalowich J, et al. Role of Topoisomerase II in Mediating Epipodophyllotoxininduced DNA Cleavage. Cancer Res 1984;44:5857-60.
  • 11. Greco F a, Johnson DH, Hainsworth JD. Chronic oral etoposide. Cancer 1991;67:303-9.
  • 12. Slevin ML, Clark PI, Joel SP, et al. A randomized trial to evaluate the effect of schedule on the activity of etoposide in small-cell lung cancer. J Clin Oncol 1989; 7:1333-40.
  • 13. De Wit R, Van Der Burg MEL, Gaast A V.d, et al. Phase II study of prolonged oral etoposide in patients with ovarian cancer refractory to or relapsing within 12 months after platinum-containing chemotherapy. Ann Oncol 1994;5:656-7.
  • 14. Seymour MT, Mansi JL, Gallagher CJ, et al. Protracted oral etoposide in epithelial ovarian cancer: A phase II study in patients with relapsed or platinum-resistant disease. Br J Cancer 1994;69:191-5.
  • 15. Kavanagh JJ, Tresukosol D, De Leon CG, et al. Phase II study of prolonged oral etoposide in refractory ovarian cancer. International Journal of Gynecological Cancer 1995;5:351-4.
  • 16. Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours : Revised RECIST guideline (version 1.1). Eur J Cancer 2008;45: 228-47.
  • 17. Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. Journal of the National Cancer Institute 2000;92:205-16.
  • 18. Hoskins BPJ, Swenerton KD. Oral Etoposide Is Active Against Platinum-Resistant Epithelial Ovarian Cancer. J Clin Oncol 1994;12:60-3.
  • 19. Moosavi AS, Gilani MM, Tehranian A, et al. Daily lowdose oral etoposide for recurrent epithelial ovarian cancer after platinum-based therapy. J Obs Gynaecol 2004;24:292-3.
  • 20. Ozols RF. Oral etoposide for the treatment of recurrent ovarian cancer. Drugs 1999;58:43-9.
  • 21. Rose PG, Blessing JA, Mayer AR, et al. Prolonged oral etoposide as second-line therapy for platinumresistant and platinum-sensitive ovarian carcinoma: A gynecologic oncology group study. J Clin Oncol 1998;16:405-10.
  • 22. Thavaramara T, Tangjitgamol S, Manusirivithaya S, et al. Oral etoposide for refractory or recurrent epithelial ovarian cancer. J Med Assoc Thai 2009;92:1397-405.
  • 23. Bozkaya Y, Dogan M, Gokmen UE, et al. Effectiveness of low-dose oral etoposide treatment in patients with recurrent and platinum-resistant epithelial ovarian cancer. Journal of Obstetrics and Gynaecology 2017; 37:649-54.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

Sleep quality and frequency of comorbidities and its relation with chronic migraine related disability in patients with chronic migraine

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The prevalence and distribution of hypodontia in 9-16 years old children

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