Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer
Abstract
:1. Introduction
1.1. Current Standard of Treatment
1.2. Gap in Knowledge of Current Standard of Therapy
1.3. Rationale of Dose-Dense Therapy
1.4. Previous Studies for Dose-Dense Therapy
2. Materials and Methods
2.1. Patient Population
2.2. Treatment
2.3. Assessments
2.4. Statistical Analysis
3. Results
3.1. Clinical Characteristics and Pathological Status
3.2. Adverse Events (AEs)
3.3. Outcomes
3.4. Prognostic Factors
4. Discussion
4.1. Main Findings
4.2. Summary of Studies Addressing Dose-Dense therapy: Survival Outcome (Table 5)
4.3. Dose-Dense Therapy-Related Adverse Events: Prefer the Use of Low-Dose Cisplatin in Place of Carboplatin in Platinum-based Therapy
4.4. The Benefits of Maximal Cytoreductive Surgery and The Consideration of the Location of Residual Tumors
4.5. The Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
Abbreviation
Adverse events (AEs) |
American Society of Clinical Oncology (ASCO) |
Area under the curve (AUC) |
Confidence interval (CI) |
Epithelial tubo-ovarian cancer (ETOC) |
Estimated glomerular filtration rate (eGFR) |
Every four weeks (Q4W) |
Every three weeks (Q3W) |
Granulocyte colony-stimulating factor (GCSF) |
Gynecologic Cancer InterGroup (GCIG) |
Gynecologic Oncology Group (GOG) |
Hazard ratio (HR) |
International Collaboration on Ovarian Neoplasms (ICON) |
International Federation of Gynecology and Obstetrics (FIGO) |
Interval cytoreductive surgery (ISC) |
Intravenous (IV) |
Intraperitoneal (IP) |
Japanese Gynecologic Oncology Group (JGOG) |
National Cancer Institute’s Common Terminology Criteria for Adverse Events (NCI-CTCAE) |
National comprehensive Cancer Network (NCCN) |
Neoadjuvant chemotherapy (NACT) |
Net health benefits (NHBs) |
Magnetic resonance image (MRI) |
Multicentre Italian Trials in Ovarian cancer (MITO) |
Overall survival (OS) |
Poly(ADP-ribose) polymerase (PARP) inhibitors (PARP inhibitors) |
Primary peritoneal serous carcinoma (PPSC) |
Primary cytoreductive surgery (PSC) |
Primary debulking surgery (PDS) |
Progression-free survival (PFS) |
Progressive disease (PD) |
Quality of life (QOL) |
Response Evaluation Criteria in Solid Tumors (RECIST) |
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Carboplatin | Cisplatin | p | |
---|---|---|---|
Number of patients | 22 | 18 | |
Age (years) | 58.5 ± 9.4 | 59.4 ± 9.4 | 0.768 |
Size of residual tumors | 0.949 | ||
≤1cm | 12 (54.5%) | 10 (55.6%) | |
>1cm | 10 (45.5%) | 8 (44.4%) | |
Site of residual tumor | 0.676 | ||
Localized | 12 (54.5%) | 11 (61.1%) | |
Whole abdominal cavity | 10 (45.5%) | 7 (38.9%) | |
Period to complete the front-line chemotherapy | 0.018 | ||
≤21 weeks | 12 (54.5%) | 16 (88.9%) | |
>21 weeks | 10 (45.5%) | 2 (11.1%) | |
ECOG | 0.884 | ||
0-1 | 21 (95.5%) | 17 (94.4%) | |
2-3 | 1 (4.5%) | 1 (5.6%) |
Events | Any grade, n (%) | Grade 3/4, n (%) | ||||
---|---|---|---|---|---|---|
CARBO | CIS | p | CARBO | CIS | p | |
Neutropenia | 20 (90.9) | 7 (38.9) | < 0.0001 | 17 (77.3) | 5 (27.8) | 0.002 |
Anemia | 21 (95.5) | 18 (100) | 0.360 | 5 (22.7) | 1 (5.6) | 0.130 |
Thrombocytopenia | 5 (22.7) | 3 (16.7) | 0.634 | 3 (13.6) | 0 | 0.103 |
Renal toxicity | 1 (4.5) | 3 (16.7) | 0.204 | 0 | 0 | |
Proteinuria | 5 (22.7) | 1 (5.6) | 0.130 | 0 | 0 | |
Peripheral neuropathy | 8 (36.4) | 7 (38.9) | 0.870 | 0 | 0 | |
Nausea | 9 (40.9) | 9 (50.0) | 0.565 | 0 | 0 |
Parameters | Univariate Analysis | Multivariate Analysis | |||
---|---|---|---|---|---|
n | HR (95% CI) | p | HR (95% CI) | p | |
Size | |||||
≤1cm | 22 | 1(Ref) | 1(Ref) | ||
>1cm | 18 | 8.68 (3.23–23.35) | <0.0001 | 14.38 (4.18–49.46) | <0.0001 |
Site | |||||
Localized | 23 | 1 (Ref) | 1 (Ref) | ||
WAC | 17 | 1.38 (0.61–3.14) | 0.440 | 0.71 (0.28–1.82) | 0.470 |
Period | |||||
≤21 weeks | 28 | 1 (Ref) | 1 (Ref) | ||
>21 weeks | 12 | 28.49 (8.36–97.06) | <0.0001 | 81.24 (14.03–470.31) | <0.0001 |
Parameters | Univariate Analysis | Multivariate Analysis | |||
---|---|---|---|---|---|
n | HR (95% CI) | p | HR (95% CI) | p | |
Size | |||||
≤1cm | 22 | 1(Ref) | 1(Ref) | ||
>1cm | 18 | 22.37 (2.88–173.86) | 0.003 | 11.83 (1.48–94.72) | 0.020 |
Site | |||||
Localized | 23 | 1 (Ref) | 1 (Ref) | ||
WAC | 17 | 2.41 (0.79–7.39) | 0.122 | 2.54 (0.76–8.53) | 0.131 |
Period | |||||
≤21 weeks | 28 | 1 (Ref) | 1 (Ref) | ||
>21 weeks | 12 | 15.31 (4.13–56.78) | <0.0001 | 9.57 (2.34–39.18) | 0.002 |
Authors | Stage | n | Regimen | PFS | OS |
---|---|---|---|---|---|
Prospective randomized trials | |||||
Katsumata [40] | II–IV | 312 | P 80 mg/m2 (D1,8,15), C 6 (D1) | 28.2 (M) | 100.5 (M) |
Pignata [32] | IC-IV | 406 | P 60 mg/m2 (D1,8,15), C 2 (D1,8,15) | 18.3 (M) | |
Chan [41] | II–IV | 340 | P 80 mg/m2 (D1,8,15), C 6 ±BEV (D1) | 14.7 (M) | - |
55 | P 80mg/m2 (D1,8,15), C 6 (D1) | 14.2 (M) | - | ||
Clamp [33] | I-IV | P 80 mg/m2 (D1,8,15), C 5,6 ± BEV (D1) | 20.8 (M) | ||
P 80 mg/m2 (D1,8,15), C 2 (D1,8,15) ± BEV (D1) | 21.0 (M) | ||||
Walker [72] | II–IV | 521 | P 80 mg/m2 (D1,8,15), C 6 +BEV (D1) | 24.9 (M) | 75.5 (M) |
Retrospective study, including phase II study | |||||
Abaid [132] | III-IV | 88 | P 80 mg/m2 (D1,8,15), C 5 (D1), stop one week | 22.5 (M) | 31.5 (M) |
Fleming [133] | III-IV | 33 | P 80 mg/m2 (D1,8,15), C 5 + BEV (D1) | 16.9-22.4 (M) | |
Murphy [102] | III | 38 | P 80 mg/m2 (D1,8,15), C 5 (D1) | 31.3 (m) | 54.5 (m) |
Boraska Jelavić [105] | I-IV | 43 | P 80 mg/m2 (D1,8,15), C 5 (D1) | 20-24 (M) | |
Rettenmaier [78] | I-IV | 100 | P 80 mg/m2 (D1,8,15), C 5 (D1) | 27.6 (M) | |
Cheng [101] | IIIC-IV | 32 | P 80 mg/m2 (D1,8,15), Cisplatin 20 mg/m2 (D1) | 27.0 (M) | 56 (m) |
Current study | IIIC | 18 | P 80 mg/m2 (D1,8,15), Cisplatin 20 mg/m2 (D1) | 30.0 (M) | 58.5 (M) |
22 | P 80 mg/m2 (D1,8,15), C 5 (D1) | 25.0 (M) | 55.0 (M) |
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Huang, C.-Y.; Cheng, M.; Lee, N.-R.; Huang, H.-Y.; Lee, W.-L.; Chang, W.-H.; Wang, P.-H. Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer. Int. J. Environ. Res. Public Health 2020, 17, 2213. https://doi.org/10.3390/ijerph17072213
Huang C-Y, Cheng M, Lee N-R, Huang H-Y, Lee W-L, Chang W-H, Wang P-H. Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer. International Journal of Environmental Research and Public Health. 2020; 17(7):2213. https://doi.org/10.3390/ijerph17072213
Chicago/Turabian StyleHuang, Chen-Yu, Min Cheng, Na-Rong Lee, Hsin-Yi Huang, Wen-Ling Lee, Wen-Hsun Chang, and Peng-Hui Wang. 2020. "Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer" International Journal of Environmental Research and Public Health 17, no. 7: 2213. https://doi.org/10.3390/ijerph17072213