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Treosulfan in platinum-resistant ovarian cancer
  1. Katrine Dam Olesen1,2,
  2. Anja Tolstrup Rædkjær Larsen1,2,
  3. Lars Henrik Jensen2,3,
  4. Karina Dahl Steffensen2,3 and
  5. Stine Rauff Søndergaard2,3
  1. 1 Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
  2. 2 Department of Oncology, Lillebælt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
  3. 3 Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
  1. Correspondence to Katrine Dam Olesen, Faculty of Health Sciences, University of Southern Denmark, Odense 7100, Denmark; katrine_dam92{at}hotmail.com

Abstract

Objectives Treosulfan is offered as last-line treatment in patients with end-stage ovarian cancer. This retrospective study aimed to evaluate the response rates, overall survival, and adverse events of treosulfan in this patient population.

Methods The study included patients with end-stage platinum-resistant ovarian cancer treated with treosulfan from October 2015 to October 2020 at the Department of Oncology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark. Patients were included for treatment if their cancer had progressed and if other treatment options were limited. Patients receiving treosulfan as first-line treatment were excluded from the study. Response rates were evaluated according to the combined criteria of CA125 and Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Kaplan–Meier survival analyses were used to illustrate progression-free and overall survival. Adverse events were graded 1–5 according to the Common Terminology Criteria for Adverse Events version 5.0.

Results Sixty-seven patients with a median age of 72 years (range 33–92) were identified. Sixty-three (94%) patients were diagnosed with serous adenocarcinoma. Fifty-seven (85%) patients were Federation of International Gynecology and Obstetrics (FIGO) stage III or IV at the time of diagnosis. The median number of treatments prior to treosulfan treatment was 3 (range 1–8). One patient had a complete response (2%), eight patients had a partial response (13%), and 22 patients (35%) had stable disease as the best response. The median duration of response (complete or partial) was 239 days (range 43–572). Median progression-free survival was 63 days (95% CI 41 to 77). The most common adverse events were anemia (83%), fatigue (83%), anorexia (62%), nausea (57%), and constipation (41%).

Conclusions Treosulfan is an alternative for the treatment of relapsed ovarian cancer when other treatment options are limited, with response rates of approximately 15%. In general, the treatment was well tolerated. Taking the mild adverse events and the response rates into account, palliative treosulfan mainly seems beneficial for patients with performance status 0–1.

  • ovarian cancer
  • neoplasm recurrence
  • local
  • palliative care
  • ovary
  • peritoneum

Data availability statement

Data are available upon reasonable request. In accordance with the journal’s guidelines, we will provide our data for the reproducibility of this study in other centers if such is requested.

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Data availability statement

Data are available upon reasonable request. In accordance with the journal’s guidelines, we will provide our data for the reproducibility of this study in other centers if such is requested.

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Footnotes

  • Contributors KDO and ATRL contributed equally to the collection of the data and the writing of the article. KDO, ATRL and LHJ were involved in the statistical analysis. KDO, ATRL, LHJ, KDS, and SRS were involved in the study design, and LHJ, KDS, and SRS critically revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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