Article ID Journal Published Year Pages File Type
3947177 Gynecologic Oncology 2011 5 Pages PDF
Abstract

ObjectiveTo evaluate clinical activity of weekly topotecan plus carboplatin in patients with platinum-sensitive recurrent ovarian, fallopian tube, or peritoneal carcinoma.MethodsAn open-label, single-arm, multicenter Phase I/II study. Phase II was the activity assessment phase, with overall response rate (ORR) as the primary endpoint. Eligible patients (females aged ≥ 18 years) received study treatment at the maximum-tolerated dose (MTD) identified in Phase I: intravenous topotecan 2.5 mg/m2 (Days 1 and 8), followed by carboplatin AUC 5 (Day 1), every 21 days. A two-stage Green–Dahlberg design was used to assess efficacy of treatment. An ORR of ≤ 30% was required to conclude that treatment was ineffective.ResultsTwenty-two patients in Phase I permitted identification of the MTD. In Phase II, 55 patients (median age 64.0 years) were enrolled and included in the intent-to-treat population. There were six complete responses (10.9%) and 11 partial responses (20.0%), giving an ORR of 30.9% (17 patients; 95% CI: 18.7%, 43.1%). Median time to response and progression-free survival were 6.57 weeks (95% CI: 5.86, 12.57) and 44.29 weeks (95% CI: 36.14, 52.14), respectively. Grade 3/4 hematological toxicity caused dose reductions, treatment delays and study discontinuation. Neutropenia (Grade 3: 29%; Grade 4: 11%) was the most common hematological adverse event (AE). Fatigue (71%) and nausea (71%) were the most common drug-related non-hematologic AEs.ConclusionsThis study showed an acceptable benefit-risk profile for topotecan plus carboplatin. Further studies using alternative dose levels could help define an optimal dosing schedule for this treatment combination in patients with platinum-sensitive recurrent disease.

Research Highlights► Weekly topotecan–carboplatin was well tolerated in relapsed platinum-sensitive cancer. ► Overall response rate was 30.9%, with 6/55 and 11/55 complete and partial responses. ► Time to progression of ~ 44 weeks compared favourably with other platinum combinations.

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