Salvage chemotherapy with a combination of irinotecan hydrochloride and mitomycin C in elderly Japanese patients with gynecological malignancies: a pilot study

The efficacy and toxicity of salvage chemotherapy with a combination of irinotecan hydrochloride (CPT-11) and mitomycin C (MMC) in elderly Japanese patients with gynecological malignancies are reported. Six patients, aged 75 years or older, two with stage IV uterine cervical cancer and four with platinum- and taxane-resistant ovarian cancer, were treated. CPT-11 (120 mg/m2) was administered intravenously for 4 h with 500 ml of normal saline solution, followed by 3.5 mg/m2 of MMC with 100 ml of normal saline, administered for 60 min, on days 1 and 15 and every 5 weeks thereafter. Six patients received a total of 24 courses of treatment, which provided an opportunity to explore, in a preliminary manner, the efficacy and toxicity of this approach. All patients demonstrated reasonable tolerance to this management strategy. There were no deaths attributable to toxicity. In a carefully selected patient population, CPT-11 and MMC chemotherapy could be administered to elderly Japanese patients with gynecological malignancies. Phase I and II studies are needed to confirm the feasibility of this treatment.