Comparison of Weekly Paclitaxel Regimens in Recurrent Platinum-Resistant Ovarian Cancer: A Single Institution Retrospective Study
, Louis-Philippe Grenier 2, Nicolas Foucault 3, Éric Lévesque 1, François Fabi 4, Eve-Lyne Langlais 5, Alexandra Sebastianelli 5, Marianne Lavoie 1, Marc Lalancette 1, Marie Plante 5, Mahukpe Narcisse Ulrich Singbo 6 and Vincent Castonguay 1,*
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsIn this paper, the Authors present retrospective data, collected from a single institution, over the last ten years, comparing the efficacy and safety of two different weekly paclitaxel regimens, in patients with platinum-resistant ovarian carcinoma
The paper is well written and the English language is appropriate and understandable.
The clinical topics are fascinating due to the paucity of data available to guide clinical decision-making in this challenging population.
To date available data are limited, level I evidence is lacking, and there is currently no consensus on the optimal therapeutic strategy in case of platinum resistance.
The primary endpoint (i.e. the cumulative dose of paclitaxel delivered, using 80 mg/m2/week, administered using either a 3-weeks out of 4 or a 4-weeks out of 4), and the additional secondary endpoints (i.e. time to next treatment, overall survival, mean duration of therapy, CA-125 response, occurrence of treatment delays, hospitalizations, neurotoxicity and the need for blood transfusions) are well studied and presented.
This paper shows a similar cumulative dose of taxane agent with a comparable efficacy profile and better tolerability of a 3 weeks out of 4 regimen compared to the continuous weekly scheme.
The limitations and bias of this retrospective study including the clinicians’ selection of the chemotherapy regimen are thoroughly reported by the Authors.
Author Response
We appreciate this positive feedback and would like to thank the reviewer for its contribution to our article.
Reviewer 2 Report
Comments and Suggestions for AuthorsThe manuscript by Morin et al has sought to evaluate clinical outcomes associated with WP3 and WP4 paclitaxel treatment regimens in platinum resistant ovarian cancer patients.
The manuscript is well written, is clear and concise and provides an excellent background introduction.
Minor comments
1. Please include statistics in Table 1 to demonstrate whether there are any differences between the two cohorts.
2. Can the authors address/assess the economic cost reduction per patient for WP3 versus WP4 regiments?
Author Response
Comment 1 : Please include statistics in Table 1 to demonstrate whether there are any differences between the two cohorts.
Response 1 : The P values were added to Table 1.
Comment 2 : Can the authors address/assess the economic cost reduction per patient for WP3 versus WP4 regiments?
Response 2 : The estimated costs of WP were added at lines 230-233. However, please note that this is an estimation from our center, hence may differ depending on local fees.
We appreciate this constructive feedback and would like to thank the reviewer for its contribution to our article.
Reviewer 3 Report
Comments and Suggestions for AuthorsThe management of patients with platinum-resistant ovarian cancer is an important issue. The primary objective of this study was to compare the cumulative dose of paclitaxel delivered using 80 mg/m2/week, administered using either a 3-week out of 4 (WP3) or a 4-week out of 4 (WP4) regimen in 149 patients with platinum-resistant ovarian carcinoma treated at the authors' center over the last ten years.
The authors need to explain why the primary objective of this study was to compare the cumulative dose of paclitaxel delivered. Is there any relation between the cumulative dose of paclitaxel and efficacy? With regard to platinum-based regimens, a correlation between cumulative doses and survival has not been reported [PMID 8482557 & 8636743].
Line 100. What is ECOG?
Table 1. P values are necessary.
Line 151. What type of blood was transfused? Please explain.
Author Response
Comment 1 : The authors need to explain why the primary objective of this study was to compare the cumulative dose of paclitaxel delivered. Is there any relation between the cumulative dose of paclitaxel and efficacy? With regard to platinum-based regimens, a correlation between cumulative doses and survival has not been reported [PMID 8482557 & 8636743].
Response 1 : We added a justification at lines 77-80. We transposed the hypothesis from a similar study with Bortezomib, where weekly administration resulted in a better tolerability than bi-weekly with a better tolerability profile.
Comment 2: Line 100. What is ECOG?
Response : We did not define ECOG in the article since it is a worldwide well used oncological term, but a reference was added at line 104.
Comment 3 : Table 1. P values are necessary.
Response 3 : The P values were added to Table 1.
Comment 4 : Line 151. What type of blood was transfused? Please explain.
Response 4 : Precisions were added at line 157 as to which blood type was transfused (packed red blood cells).
We appreciate this constructive feedback and would like to thank the reviewer for its contribution to our article.
Round 2
Reviewer 3 Report
Comments and Suggestions for AuthorsIn this version of the manuscript, some issues I pointed out are revised.
