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Topotecan and liposomal doxorubicin in recurrent ovarian cancer: is sequence important?
  1. J. Dupont*,,
  2. C. Aghajanian*,,
  3. G. Andrea*,,
  4. M. Lovegren*,,
  5. S. Chuai*,,
  6. E. Venkatraman,,
  7. M. Hensley*,,
  8. S. Anderson*,,
  9. D. Spriggs*, and
  10. P. Sabbatini*,
  1. * Developmental Chemotherapy Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
  2. Department of Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York
  3. The Joan and Sanford I. Weill Medical College of Cornell University, New York, New York
  1. Address correspondence and reprint requests to: Jakob Dupont, MD, Developmental Chemotherapy Service, Department of Medicine, Howard 903, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA. Email: dupontj{at}


A variety of agents have emerged to treat patients with recurrent epithelial ovarian cancer (EOC). Most patients receive both topotecan (T) and liposomal doxorubicin (D); however, there are no data regarding the benefit of a sequence—D followed by T (DT) or T followed by D (TD). We identified 89 consecutive patients with recurrent EOC, who received both D and T from January 1994 to January 2004 at Memorial Hospital. We compared the duration of treatment, toxicity, and overall survival (OS) for patients who received either DT or TD. Sixty-four patients received DT, and 25 patients received TD. The groups were balanced regarding age, stage, surgical debulking, platinum sensitivity, prior therapy, and intervening drugs between D and T. Median numbers of cycles on DT and TD were seven and six, respectively (P= 0.61); there was no difference in duration based on platinum sensitivity. Removal from therapy for toxicity was similar, DT (22%) and TD (36%) (P= 0.18). Finally, there was no difference in median OS based on sequence, DT (18.28 months) and TD (17.75 months) (P= NS). Platinum sensitivity did not affect median OS based on sequence. Based on duration, toxicity, and OS there is no advantage of one sequence of D and T when treating patients with recurrent EOC.

  • liposomal doxorubicin
  • ovarian cancer
  • sequencing
  • topotecan

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