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The use of continuous infusion topotecan in persistent and recurrent ovarian cancer
  1. J. C. Elkas,
  2. C. H. Holschneider,
  3. B. Katz,
  4. A. J. Li,
  5. R. Louie,
  6. K. F. Mcgonigle and
  7. J. S. Berek
  1. Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
  1. Address correspondence and reprint requests to: Jonathan Berek, MD, Division of Gynecologic Oncology Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Center for Health Sciences, 10833 Le Conte Avenue, Los Angeles, California 90095–1740, Email: jberek{at}mednet.ucla.edu.

Abstract

We retrospectively review our experience with continuous infusion topotecan for the treatment of persistent or recurrent ovarian cancer in this paper. Nine patients were identified who were treated at the University of California Los Angeles Medical Center between January 1997 and December 1999 using a 14–21 day continuous infusion schedule (0.3–0.7 mg/m2/d). Dose adjustments were performed for grade 3–4 toxicities and treatment was discontinued for persistent severe toxicity or progressive disease. Response to treatment was analyzed and stratified by platinum refractory, resistant, and sensitive disease. A total of 41 treatment cycles were given to nine patients with a median of five per patient (range 1–11). Median follow-up was 8 months. There were two partial responses (22%) and four patients had stable disease (44%), which included two patients with platinum-refractory tumors. No grade 3 or 4 hematologic toxicities were observed. However, two patients suffered grade 3 gastrointestinal toxicity during the first cycle leading to discontinuation of topotecan administration. There was no cumulative toxicity. Topotecan administered by continuous infusion demonstrated response rates comparable to other dosing schedules with minimal hematologic toxicity. Treatment of patients with persistent or recurrent ovarian cancer with continuous infusion topotecan warrants further investigation.

  • continuous infusion
  • ovarian cancer
  • recurrent
  • persistent disease
  • second line therapy
  • topotecan

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Footnotes

  • The opinions contained herein are the views of the authors and are not necessarily the views of the Department of Defense or the Department of the Navy.

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