Cisplatin, etoposide "highly effective" in ovarian cancer studies

LONDON (Reuters Health) – A new type of intensive chemotherapy using weekly cisplatin and daily oral etoposide is "highly effective" in women with platinum-refractory ovarian cancer, Dutch researchers reported on Friday.

The study, published in the British Journal of Cancer, involved 98 women with ovarian cancer whose first-line chemotherapy had initially been successful but who had later relapsed.

Thirty-eight women had relapsed more than 12 months after their initial treatment, 32 had relapsed between four and 12 months later, while 28, the most seriously ill, had relapsed less than four months later.

The therapy consisted of six weekly intravenous cisplatin infusions at either 50 mg or 70 mg per m2 plus oral etoposide at a dose of 50 mg daily.

The response rates of the three groups to the new treatment were 92%, 91% and 46%, respectively. This compares with responses of 50%, 20-30% and less than 15% with standard therapies.

Despite prior treatment with platinum compounds, with 22% of the patients having received two platinum-containing regimens and 3% of the patients having received three platinum-containing regimens, neurotoxicity and renal toxicity was "notably mild," and there were few haematological complications, the researchers said.

"We were delighted by the success of the study," Dr Ronald de Wit, of the Rotterdam Cancer Institute, said. "The new drug combination was highly effective at keeping women alive for longer, giving real hope to those who would otherwise have had very little."

Cisplatin and etoposide are already used in chemotherapy regimes for many cancers, but the new treatment used the drugs much more intensively than usual. Usually, doctors give their patients several weeks to recover from the toxic side effects of cisplatin, but in the new study the drug was given on a weekly basis, along with strong drugs to prevent nausea.

"We were worried the women would be too ill to cope with the treatment, but in fact, they suffered relatively few side effects," Dr de Wit added in a news release. "And since these drugs are readily available, there's no reason why women shouldn't start to benefit from them right away."

Prof. Gordon McVie, Director General of The Cancer Research Campaign, which owns the British Journal of Cancer, said, "While current chemotherapy regimes are effective for some women with ovarian cancer, many relapse later and overall cure rates are improving only very slowly. These old drugs in a new regime will be a useful salvage."

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