Response of combination platinum and gemcitabine chemotherapy for recurrent epithelial ovarian carcinoma

Jeannine Villella, David Marchetti, Kunle Odunsi, Kerry Rodabaugh, Deborah L. Driscoll, Shashikant Lele

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

It has been postulated that gemcitabine inhibits DNA repair, and platinum resistance is due to increased DNA repair activity. The addition of gemcitabine to platinum-based agents may have synergistic tumoricidal activity. Retrospective chart review of all patients with recurrent, persistent, or progressive fallopian tube or ovarian carcinoma treated with a platinum-based compound and gemcitabine from 2001 to present was performed. Twenty-nine patients on second to eight line chemotherapy met inclusion criteria. The median age was 53 years. Twenty-two patients received cisplatin and gemcitabine, and 7 patients received carboplatin and gemcitabine based on results of chemoresistance assays or prior chemorelated toxicities. The intent to treat was with six cycles of gemcitabine (1000 mg/m2) and either cisplatin (75 mg/m2) or carboplatin (AUC 5) day 1 and gemcitabine only on day 8 of a 21-day cycle. The median number of cycles administered was six. There were 20 grade 3 and 4 toxicities and 63% of patients by cycle 6 needed erythropoietin marrow support and 19% needed GCSF support by cycle 4. Twenty-one patients required discontinuation of day 8 that most commonly occurred at cycle 4. Eleven (38%) had CR, 5 (17%) had PR, 6 (21%) had SD, and 7 (24%) had PD, which is a 55% overall response. Nineteen of 29 patients (66%) showed platinum resistance to initial therapy. Of those, four (21%) had CR, four (21%) had PR, six (32%) had SD, and five (26%) with PD, which demonstrates a 42% overall response rate for this particular subset of patients. Adjuvant combination platinum-based agent with gemcitabine is a very effective and well-tolerated treatment for recurrent fallopian tube or ovarian carcinoma; even in those who exhibit initial platinum resistance.

Original languageEnglish (US)
Pages (from-to)539-545
Number of pages7
JournalGynecologic Oncology
Volume95
Issue number3
DOIs
StatePublished - Dec 2004
Externally publishedYes

Keywords

  • Carboplatin
  • Cisplatin
  • Epithelial ovarian cancer
  • Gemcitabine
  • Platin resistance
  • Response

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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