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A pilot study of topotecan in the treatment of serous carcinoma of the uterus
  1. J. T. Chambers*,
  2. T. J. Rutherford*,
  3. P. E. Schwartz*,
  4. M. L. Carcangiu,
  5. S. K. Chambers* and
  6. L. Baker*
  1. * Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut
  2. Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
  1. Address correspondence and reprint requests to: Joseph T. Chambers, PhD, MD, St. Luke's-Roosevelt Hospital Center, Department of OB/GYN Administration, 1000 10th Ave., 10C01, New York, NY 10019. Email: Joseph_Chambers{at}chpmet.org

Abstract

A pilot study investigated topotecan (Hycamtin, GlaxoSmithKline, Philadelphia, PA), a topoisomerase I inhibitor, in treating uterine serous carcinoma, a typically unresponsive aggressive tumor. Fifteen patients were surgically staged, then treated with topotecan (1.5 mg/m2, Days 1–5 every 21 days) as first-line therapy (n = 12) or secondary to platinum failure (n = 3). Patients received topotecan through six courses, disease progression, or unacceptable toxicity. Grade 3/4 hematologic toxicity prompted dose adjustments. Thirteen patients exhibited no gross evidence of residual disease postoperatively. At topotecan initiation, one patient had 5-cm and one had < 1-cm residual disease. Seventy-eight courses (median, six) were administered; 12 (80%) patients completed the specified protocol. Common serious toxicities included grade 3 neutropenia (33%), anemia (13%), and thrombocytopenia (13%). Eight patients received erythropoietin and/or granulocyte colony-stimulating factor. Median follow-up for 14 evaluable patients was 26 months (range, 13–40). Of 11 evaluable first-line topotecan patients, nine were alive at follow-up; five were disease-free. Of three second-line topotecan patients, two died and one was alive with disease 31 months post-treatment. One patient with measurable disease achieved a complete and one a partial response as assessed by computed tomography scan. Median progression-free survival was 25 months; median survival has not been reached at 26 months. Although topotecan's antitumor activity cannot yet be quantified, disease-free interval and survival outcomes compare favorably with other therapies in uterine serous carcinoma. Further evaluation of topotecan in this population is warranted.

  • Hycamtin
  • myelosuppression
  • topoisomerase I inhibitor
  • topotecan
  • uterine serous carcinoma

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Footnotes

  • This research was sponsored by GlaxoSmithKline, Brentford, Middlesex, UK.

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