Efficacy and safety of dose-dense paclitaxel plus carboplatin as neoadjuvant chemotherapy for advanced ovarian, fallopian tube or peritoneal cancer

• Published in: Japanese journal of clinical oncology 2017-11, Vol.47 (11), p.1019-1023
• Main Authors: Yoshihama, Tomoko, Nomura, Hiroyuki, Iwasa, Naomi, Kataoka, Fumio, Hashimoto, Shiho, Nanki, Yoshiko, Hirano, Takuro, Makabe, Takeshi, Sakai, Kensuke, Yamagami, Wataru, Hirasawa, Akira, Aoki, Daisuke
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carboplatin - administration & dosage; Disease-Free Survival; Fallopian Tube Neoplasms - drug therapy; Fallopian Tube Neoplasms - mortality; Female; Humans; Middle Aged; Neoadjuvant Therapy; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - mortality; Paclitaxel - administration & dosage; Peritoneal Neoplasms - drug therapy; Peritoneal Neoplasms - mortality; Retrospective Studies
• ISSN: 0368-2811; 1465-3621
• DOI: 10.1093/jjco/hyx118

Interval debulking surgery (IDS) after neoadjuvant chemotherapy (NAC) is currently one of the preferred treatment options for advanced ovarian, fallopian tube or peritoneal cancer. This study was conducted to evaluate the clinical efficacy and safety of dose-dense paclitaxel plus carboplatin therapy (ddTC therapy) as NAC for these cancers. A retrospective study was conducted in 25 patients with Stage III/IV ovarian, fallopian tube or peritoneal cancer who received ddTC therapy as NAC. For ddTC therapy, paclitaxel (80 mg/m2) was administered intravenously on Days 1, 8 and 15 and carboplatin (AUC 6.0 mg/ml × min) was administered intravenously on Day 1 every 3 weeks. IDS was performed after three cycles of ddTC therapy, and ddTC therapy was also continued after surgery. With ddTC therapy as NAC, the response rate was 92% and disease progression did not occur in any patient. Grade 4 hematologic toxicity and ≥Grade 3 non-hematologic toxicity both occurred in 8% of the patients, but no patient discontinued NAC because of adverse events. When IDS was performed, the complete surgery rate was 64% and the optimal surgery rate was 96%. ≥Grade 3 perioperative complications occurred in 16% of the patients, but there were no perioperative deaths. Median overall survival was 35.7 months and median progression-free survival was 17.7 months. This study showed that ddTC therapy was considerably effective and tolerable as NAC. The complete surgery rate was high with IDS, and perioperative complications were acceptable.