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Third-line chemotherapy in platinum- and paclitaxel-resistant ovarian, fallopian tube, and primary peritoneal carcinoma patients
  1. S. Tangjitgamol*,
  2. H. T. See*,
  3. S. Manusirivithaya,
  4. C. F. Levenback,
  5. D. M. Gershenson and
  6. J. J. Kavanagh*
  1. * Department of Gynecologic Medical Oncology, The University of Texas, M.D. Anderson Cancer Center, Houston, TX
  2. Department of Gynecologic Oncology, The University of Texas, M.D. Anderson Cancer Center, Houston, TX
  3. Clinical Epidemiology Unit, Bangkok Metropolitan Administration Medical College and Vajira Hospital, Bangkok, Thailand
  1. Address correspondence and reprint requests to: John J. Kavanagh, Department of Gynecologic Medical Oncology, Unit 401, The University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030. Email: jkavanag{at}mdanderson.org

Abstract

Ovarian carcinoma is a malignant disease with a high rate of recurrence, necessitating repeated chemotherapy treatments. We conducted a retrospective study in patients with platinum- and paclitaxel-resistant ovarian, fallopian tubes and primary peritoneal carcinoma patients treated at M.D. Anderson Cancer Center. We evaluated the responses, progression-free intervals, and overall survival duration of 51 patients after third-line chemotherapy treatment. The overall response rate was 16% (eight cases) with 2% complete response rate (one case) and 14% partial response rate (seven cases). Stable disease was achieved in 31% (16 cases). The progression-free intervals of 24 patients who had response and stable disease was 7.4 months (range, 1.4–18.4 months). The median overall survival of all patients was 15.8 months (95% CI, 8.1–23.4 months). The median survival duration of eight responders was not significantly different from that of 43 nonresponders, 18.9 months (95% CI, 2.4–35.4 months) versus 15.8 months (95% CI, 6.4–25.2 months), respectively (P = 0.73). In conclusion, third-line chemotherapy in our study results in a modest response and prolongation of progression-free interval without obvious impact on survival. The decision to utilize third-line chemotherapy will be a balance of the limited efficacy, toxicity of the agents, and the expertise of the clinician.

  • fallopian tube carcinoma
  • ovarian carcinoma
  • primary peritoneal carcinoma
  • response rate
  • third-line drugs

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