The activity of taxanes compared with bleomycin, etoposide, and cisplatin in the treatment of sex cord-stromal ovarian tumors.

Abstract

OBJECTIVE:

We compared the efficacy and side effects of taxanes, with or without platinum, to bleomycin, etoposide, and cisplatin (BEP) in treating sex cord-stromal ovarian tumors.

METHODS:

We conducted a retrospective review of all patients with sex cord-stromal ovarian tumors seen at our institution from 1985 to 2002. Eligible patients were those who underwent pathologic confirmation, clinical evaluation, and treatment with a taxane or BEP for initial or recurrent disease.

RESULTS:

Of 222 patients identified, 21 received BEP for new (n = 11) or recurrent disease (n = 10); 44 received a taxane during 48 treatment episodes (four patients on two occasions each) for new (n = 11) or recurrent disease (n = 37). Newly diagnosed patients treated with BEP vs. taxanes had no significant difference in response rate (Fisher's exact test, P = 1), progression-free survival (PFS) (log-rank test, P = 0.213), or overall survival (log-rank test, P = 0.994). Among patients treated for recurrent measurable disease, the response rate was higher for BEP-treated (71%) than for taxane-treated patients (37%), but this was not statistically significant. In all patients treated for recurrent disease, there was no significant difference in failure to progress at chemotherapy completion between BEP- (70%) and taxane-treated patients (62%) or in median PFS (11.2 vs. 7.2 months). The presence of platinum in taxane-containing regimens correlated with response. Taxane-related side effects included neutropenia (n = 6), anemia (n = 1), thrombocytopenia (n = 1), myelodysplasia (n = 1), and hypersensitivity (n = 1). BEP-related side effects included pulmonary fibrosis (n = 3) and neutropenia (n = 2).

CONCLUSIONS:

Taxanes demonstrated activity against sex cord-stromal tumors of the ovary and may be less toxic than BEP. Taxane and platinum combination chemotherapy warrants further investigation in this disease.

• Authors: Jubilee Brown, Hyun S Shvartsman, Michael T Deavers, Lois M Ramondetta, Thomas W Burke, Mark F Munsell, David M Gershenson
• Journal: Gynecologic oncology (Gynecol Oncol) Vol. 97 Issue 2 Pg. 489-96 (May 2005) ISSN: 0090-8258 [Print] United States
• PMID: 15863149 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Organoplatinum Compounds
• Taxoids
• Bleomycin
• Docetaxel
• Etoposide
• Paclitaxel
• Cisplatin

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects, therapeutic use)
• Bleomycin (administration & dosage, adverse effects)
• Cisplatin (administration & dosage, adverse effects)
• Docetaxel
• Etoposide (administration & dosage, adverse effects)
• Female
• Humans
• Middle Aged
• Neoplasm Staging
• Organoplatinum Compounds (administration & dosage, adverse effects)
• Ovarian Neoplasms (drug therapy, pathology)
• Paclitaxel (administration & dosage, adverse effects, therapeutic use)
• Retrospective Studies
• Sex Cord-Gonadal Stromal Tumors (drug therapy, pathology)
• Taxoids (administration & dosage, adverse effects, therapeutic use)