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An Outpatient, Dose-Intense, Intravenous Cisplatin and Oral Etoposide Regimen for the Treatment of Advanced, Platinum-Resistant Ovarian Cancer
  1. Robert D. Morgan, MD,
  2. Andrew R. Clamp, PhD,
  3. Jurjees Hasan, MD,
  4. Claire Mitchell, PhD,
  5. Geoff Saunders, MPhil,
  6. Nerissa Mescallado, MD,
  7. Richard Welch, MD and
  8. Gordon C. Jayson, PhD
  1. The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom.
  1. Address correspondence and reprint requests to Gordon C. Jayson, PhD, The Christie Hospital NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, United Kingdom. E-mail: gordon.jayson2{at}


Objectives Advanced-stage, platinum-resistant, ovarian cancer can be treated with dose-intense chemotherapy; one such regimen includes intravenous cisplatin and oral etoposide. To minimize the toxicity associated with weekly cisplatin, pretreatment and posttreatment hydration is required, often necessitating inpatient, overnight admission. We report a shorter, within-day regimen for delivering weekly cisplatin.

Methods This was a retrospective study to assess the use of standard (inpatient; treatment time of 12 hours) versus modified (outpatient; treatment time of 4 hours) regimens. The primary outcome included all-grade and grade 3/4 adverse events. Secondary outcomes included clinical benefit response and, median progression-free survival and overall survival.

Results Between January 2012 and December 2014, 66 women with metastatic ovarian cancer received dose-intense weekly cisplatin and oral etoposide (n = 45 standard, n = 21 modified). The commonest all-grade adverse events were anemia (96% vs 90%, standard and modified, respectively), fatigue (73% vs 67%), neutropenia (71% vs 76%), hypocalcemia (51% vs 43%), and thrombocytopenia (49% vs 57%). There were no statistically significant differences in the incidence or grades of adverse events. The clinical benefit response was 53% in the standard group and 62% in the modified group (P = 0.9). The median progression-free survival was 4.2 and 6.5 months (incidence rate ratio, 1.22; 95% confidence interval, 0.71–2.15; P = 0.29), and median overall survival was 6.6 and 8.4 months (incidence rate ratio, 1.83; 95% confidence interval, 1.04–3.35; P = 0.03), in favor of the modified regimen.

Conclusions Our shorter, within-day regimen for delivering dose-intense weekly cisplatin and oral etoposide to treat platinum-resistant metastatic ovarian cancer is safe and efficacious.

  • Dose intense
  • Ovarian cancer
  • Platinum resistance

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  • The authors declare no conflicts of interest.