Sustained platelet-sparing effect of weekly low dose paclitaxel allows effective, tolerable delivery of extended dose dense weekly carboplatin in platinum resistant/refractory epithelial ovarian cancer

Title: Sustained platelet-sparing effect of weekly low dose paclitaxel allows effective, tolerable delivery of extended dose dense weekly carboplatin in platinum resistant/refractory epithelial ovarian cancer
Authors: Sharma, R
Graham, J
Blagden, S
Gabra, H
Item Type: Journal Article
Abstract: Background Platinum agents have shown demonstrable activity in the treatment of patients with platinum resistant, recurrent ovarian cancer when delivered in a "dose-dense" fashion. However, the development of thrombocytopenia limits the weekly administration of carboplatin to no greater than AUC 2. Paclitaxel has a well-described platelet sparing effect however its use to explicitly provide thromboprotection in the context of dose dense carboplatin has not been explored. Methods We treated seven patients with platinum resistant ovarian cancer who had previously received paclitaxel or who had developed significant peripheral neuropathy precluding the use of further full dose weekly paclitaxel. Results We were able to deliver carboplatin AUC 3 and paclitaxel 20 mg/m2 with no thrombocytopenia or worsening of neuropathic side-effects, and with good activity. Conclusions We conclude that this regimen may be feasible and active, and could be formally developed as a "platinum-focussed dose-dense scaffold" into which targeted therapies that reverse platinum resistance can be incorporated, and merits further evaluation.
Issue Date: 11-Jul-2011
Date of Acceptance: 11-Jul-2011
URI: http://hdl.handle.net/10044/1/71763
DOI: https://doi.org/10.1186/1471-2407-11-289
ISSN: 1471-2407
Publisher: BioMed Central
Journal / Book Title: BMC Cancer
Volume: 11
Issue: 1
Copyright Statement: © 2011 Sharma et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
ovarian cancer
resistance
chemotherapy
dose-dense
carboplatin
paclitaxel
thrombocytopaenia
COMBINATION CHEMOTHERAPY
RANDOMIZED-TRIAL
PHASE-I
THERAPY
PACLITAXEL/CARBOPLATIN
TOPOTECAN
RESISTANT
CARCINOMA
CISPLATIN
LONG
Adenocarcinoma
Adenocarcinoma, Papillary
Aged
Aged, 80 and over
Antineoplastic Agents, Phytogenic
Antineoplastic Combined Chemotherapy Protocols
Area Under Curve
Blood Platelets
Carboplatin
Cisplatin
Combined Modality Therapy
Cystadenocarcinoma, Serous
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Resistance, Neoplasm
Etoposide
Female
Granulosa Cell Tumor
Humans
Middle Aged
Ovarian Neoplasms
Ovariectomy
Paclitaxel
Peripheral Nervous System Diseases
Salvage Therapy
Tamoxifen
Thrombocytopenia
Treatment Outcome
Blood Platelets
Humans
Adenocarcinoma
Adenocarcinoma, Papillary
Cystadenocarcinoma, Serous
Granulosa Cell Tumor
Ovarian Neoplasms
Peripheral Nervous System Diseases
Thrombocytopenia
Cisplatin
Paclitaxel
Tamoxifen
Carboplatin
Etoposide
Antineoplastic Agents, Phytogenic
Antineoplastic Combined Chemotherapy Protocols
Treatment Outcome
Combined Modality Therapy
Salvage Therapy
Ovariectomy
Drug Administration Schedule
Area Under Curve
Dose-Response Relationship, Drug
Drug Resistance, Neoplasm
Aged
Aged, 80 and over
Middle Aged
Female
Science & Technology
Life Sciences & Biomedicine
Oncology
ovarian cancer
resistance
chemotherapy
dose-dense
carboplatin
paclitaxel
thrombocytopaenia
COMBINATION CHEMOTHERAPY
RANDOMIZED-TRIAL
PHASE-I
THERAPY
PACLITAXEL/CARBOPLATIN
TOPOTECAN
RESISTANT
CARCINOMA
CISPLATIN
LONG
1112 Oncology and Carcinogenesis
Oncology & Carcinogenesis
Publication Status: Published
Article Number: 289
Online Publication Date: 2011-07-11
Appears in Collections:Division of Surgery
Division of Cancer
Faculty of Medicine



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