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Gemcitabine–carboplatin–paclitaxel combination as first-line therapy in advanced ovarian carcinoma: a single institution phase II study in 24 patients
  1. L. Fuso,
  2. F. Amant,
  3. P. Neven,
  4. P. Berteloot and
  5. I. Vergote
  1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University Hospitals Leuven, Katholieke Universiteit, Leuven, Belgium
  1. Address correspondence and reprint requests to: Prof. Ignace Vergote, MD, PhD, Division of Gynecologic Oncology, Department of Gynecologic Oncology, University Hospitals Leuven, Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. Email: ignace.vergote{at}uz.kuleuven.ac.be

Abstract

Single-agent gemcitabine demonstrated response rates of 11–60% in platinum/paclitaxel-resistant ovarian cancer. Twenty-four patients with epithelial ovarian cancer were treated with gemcitabine 800 mg/m2 on days 1 and 8, carboplatin area under the curve 5 on day 1, and paclitaxel 175 mg/m2 over 3 h on day 1 every 3 weeks for six cycles. Median age was 54 years, and FIGO stage distribution was IIC, 1 patient, III, 18, and IV, 5. A total of 22 (92%) patients completed all the six planned courses of chemotherapy. Doses were reduced in 8 out of 24 (33%) patients. Of the 17 patients with measurable disease, 15 underwent an interval debulking surgery. Prior to interval debulking surgery, all 15 patients had a partial response according to the response evaluation criteria in solid tumors criteria. Overall in the 17 patients with measurable disease, the response rate at the end of the first-line chemotherapy (including interval debulking) was 94% (14 [82%] complete response and 2 [12%], partial response). One patient (6%) received only one cycle due to early progression. Using the CA125 criteria as defined by the Gynecologic Cancer Intergroup, all patients had at least a partial response prior to interval debulking, and the overall response rate of the whole first-line chemotherapy and interval debulking (n= 15) was observed in 21 out of 23 patients (91%). The dose-limiting toxicity was bone marrow toxicity. Median overall survival was 28 months, and the 2-year actuarial survival was 73%. The gemcitabine, carboplatin, paclitaxel triplet has an acceptable toxicity with high response rates as first-line therapy in advanced ovarian cancer.

  • ovarian cancer
  • ovarian
  • neoplasms
  • therapy
  • chemotherapy
  • paclitaxel
  • carboplatin
  • gemcitabine

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