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Utilization of an Alternative Docetaxel-based Intraperitoneal Chemotherapy Regimen in Patients With Ovarian, Fallopian Tube or Primary Peritoneal Carcinoma

A Continued Need for Ovarian Cancer Patients

Becker, David A., MD*; Leath, Charles A. III, MD, MSPH; Walters-Haygood, Christen L., MD; Smith, Brentley Q., MD, MSPH*; Bevis, Kerri S., MD, MSPH

American Journal of Clinical Oncology: January 2019 - Volume 42 - Issue 1 - p 12–16
doi: 10.1097/COC.0000000000000468
Original Articles: Gynecologic
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Objective: The objective of this study was to report the tolerability and toxicity of a regimen consisting of intravenous (IV) docetaxel and intraperitoneal (IP) cisplatin and paclitaxel with granulocyte colony-stimulating factor support.

Materials and Methods: We conducted a retrospective cohort study of patients with surgical stage II-IV epithelial ovarian, fallopian tube or primary peritoneal carcinoma treated with an outpatient IP chemotherapy regimen consisting of docetaxel 75 mg/m2 IV and cisplatin 75 mg/m2 IP day 1 followed by paclitaxel 60 mg/m2 IP day 8 every 21 days. Grade 3 and 4 toxicity, dose delays and reductions, port complications, and tolerability are reported. Outcomes, including response rate, progression-free survival (PFS), overall survival (OS) are also reported.

Results: A total of 60 patients received this IP regimen. Most common toxicities included neutropenia (47%), gastrointestinal (28%), and anemia (25%). Most patients (85%) experienced no IP port complications. Dose delay or reduction was required in 30% of patients. Two-thirds completed all prescribed cycles, with 80% of total planned cycles completed. Complete response was achieved for 88%, and 43% are currently without evidence of disease. Median PFS for all patients was 25.5 months (95% confidence interval [CI], 20.4-30.5 mo) while OS for all patients was 56.8 months (95% CI, 47.7-65.9 mo). For the 44 patients with stage III disease, median PFS was 22.1 months (95% CI, 16.3-28.0 mo), while median OS was 56.8 months (95% CI, 47.3-66.3 mo).

Conclusions: This docetaxel-based IP chemotherapy regimen demonstrates an improved tolerability profile compared with GOG172. Additional evaluations on alternative IP regimens remain warranted. Short follow-up time limits survival assessment, but results are encouraging.

*Department of Obstetrics & Gynecology

Division of Gynecologic Oncology, University of Alabama at Birmingham, Birmingham, AL

Presented as a poster presentation at the Society of Gynecologic Oncology Annual Meeting on Women’s Cancer, 2015, Chicago, IL.

Supported in part by NIH 3P30CA013148-43S3 and 5K12HD0012580-15 to C.A.L. and K.S.B.

The authors declare no conflicts of interest.

Reprints: Charles A. Leath III, MD, MSPH, Division of Gynecologic Oncology, University of Alabama at Birmingham, 1700 6th Avenue South, Room 10250, Birmingham, AL 35233. E-mail: cleath@uabmc.edu.

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