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Yan F, Chen L, Ying M, Li J, Fu Q. Efficacy and safety of pembrolizumab combined with albumin-bound paclitaxel and nedaplatin for advanced esophageal squamous cell carcinoma. Immunotherapy 2024; 16:305-317. [PMID: 38197157 DOI: 10.2217/imt-2023-0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
Objective: This research aimed to assess the efficacy and safety of pembrolizumab (PBL) combined with albumin-bound paclitaxel (ab-Pac) and nedaplatin (NDP) for advanced esophageal squamous cell carcinoma (ESCC). Methods: A total of 47 ESCC patients were administered PBL or NDP on day 1 and ab-Pac on days 1 and 8, every 21 days for one cycle. Tumor and toxicities were evaluated every two cycles and every cycle, respectively. Results: The objective response rate was 68.1% and the disease control rate was 100%. The median follow-up was 16.7 months; median progression-free and overall survival were 12.6 and 19.9 months, respectively. Conclusion: The combination of PBL with ab-Pac and NDP proved to be an effective and safe treatment regimen for advanced ESCC.
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Affiliation(s)
- Fang Yan
- Department of Oncology, Shanghai Changhai Hospital, No. 168 Changhai Road, Shanghai, 200433, China
| | - Longpei Chen
- Department of Oncology, Shanghai Changhai Hospital, No. 168 Changhai Road, Shanghai, 200433, China
| | - Mingzhen Ying
- Department of Oncology, Shanghai Changhai Hospital, No. 168 Changhai Road, Shanghai, 200433, China
| | - Jie Li
- Department of Oncology, Shanghai Changhai Hospital, No. 168 Changhai Road, Shanghai, 200433, China
| | - Qiang Fu
- Department of Oncology, Shanghai Changhai Hospital, No. 168 Changhai Road, Shanghai, 200433, China
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2
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Aghajanian C, Swisher EM, Okamoto A, Steffensen KD, Bookman MA, Fleming GF, Friedlander M, Moore KN, Tewari KS, O'Malley DM, Chan JK, Ratajczak C, Hashiba H, Wu M, Dinh MH, Coleman RL. Impact of veliparib, paclitaxel dosing regimen, and germline BRCA status on the primary treatment of serous ovarian cancer - an ancillary data analysis of the VELIA trial. Gynecol Oncol 2021; 164:278-287. [PMID: 34930617 PMCID: PMC9399938 DOI: 10.1016/j.ygyno.2021.12.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/23/2021] [Accepted: 12/07/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE In the Phase 3 VELIA trial (NCT02470585), veliparib added to carboplatin plus paclitaxel concomitantly and as maintenance for women with newly-diagnosed advanced ovarian cancer significantly improved progression-free survival (PFS) versus chemotherapy alone. Here we present exploratory analyses by paclitaxel dosing schedule and germline BRCA (gBRCA) status. METHODS Women with untreated ovarian carcinoma were randomized (1:1:1) to: veliparib during chemotherapy and maintenance (veliparib-throughout), veliparib during chemotherapy followed by placebo maintenance (veliparib-combination only), or placebo during chemotherapy and maintenance (control). Chemotherapy included carboplatin plus dose-dense (DD; weekly) or every-3-week (Q3W) paclitaxel (a stratification factor at randomization), selected at the investigator's discretion pre-randomization. PFS was assessed by paclitaxel dosing schedule using a Cox proportional hazard model adjusted by treatment arm and stratification factors; safety was analyzed based on paclitaxel dosing schedule and gBRCA status. RESULTS 1132 patients were analyzed by paclitaxel schedule. Pooled treatment arms demonstrated longer median PFS with DD (n = 586) versus Q3W (n = 546) paclitaxel (ITT: 20.5 vs 15.7 months, hazard ratio [HR] 0.77; homologous recombination proficient cancer: 15.1 vs 11.8 months, HR 0.64; BRCAwt: 18.0 vs 12.9 months, HR 0.70). Comparison between arms favored veliparib-throughout versus control in both DD (PFS, 24.2 vs 18.3 months, hazard ratio 0.67) and Q3W (19.3 vs 14.6, hazard ratio 0.69) subgroups. DD paclitaxel was associated with higher incidence of Grade 3/4 neutropenia, fatigue, and anemia versus Q3W. There were no differences in toxicity between gBRCAm (n = 211) and gBRCAwt (n = 902) subgroups. CONCLUSIONS DD paclitaxel was tolerable and associated with longer PFS in the HR proficient and gBRCAwt groups, versus Q3W. gBRCA status did not impact safety.
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Affiliation(s)
| | - Elizabeth M Swisher
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - Karina Dahl Steffensen
- Department of Oncology, Lillebaelt University Hospital of Southern Denmark, Vejle, Denmark
| | | | | | - Michael Friedlander
- Prince of Wales Clinical School UNSW, Prince of Wales Hospital and ANZGOG, Sydney, Australia
| | - Kathleen N Moore
- Stephenson Cancer Center at the University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | | | - David M O'Malley
- The Ohio State University Comprehensive Cancer Center - James, Columbus, OH, USA
| | - John K Chan
- Palo Alto Medical Foundation, California Pacific Medical Center, Sutter Health, San Francisco, CA, USA
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McCorkle JR, Gorski JW, Liu J, Riggs MB, McDowell AB, Lin N, Wang C, Ueland FR, Kolesar JM. Lapatinib and poziotinib overcome ABCB1-mediated paclitaxel resistance in ovarian cancer. PLoS One 2021; 16:e0254205. [PMID: 34347777 PMCID: PMC8336885 DOI: 10.1371/journal.pone.0254205] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 06/22/2021] [Indexed: 11/19/2022] Open
Abstract
Conventional frontline treatment for ovarian cancer consists of successive chemotherapy cycles of paclitaxel and platinum. Despite the initial favorable responses for most patients, chemotherapy resistance frequently leads to recurrent or refractory disease. New treatment strategies that circumvent or prevent mechanisms of resistance are needed to improve ovarian cancer therapy. We established in vitro paclitaxel-resistant ovarian cancer cell line and organoid models. Gene expression differences in resistant and sensitive lines were analyzed by RNA sequencing. We manipulated candidate genes associated with paclitaxel resistance using siRNA or small molecule inhibitors, and then screened the cells for paclitaxel sensitivity using cell viability assays. We used the Bliss independence model to evaluate the anti-proliferative synergy for drug combinations. ABCB1 expression was upregulated in paclitaxel-resistant TOV-21G (q < 1x10-300), OVCAR3 (q = 7.4x10-156) and novel ovarian tumor organoid (p = 2.4x10-4) models. Previous reports have shown some tyrosine kinase inhibitors can inhibit ABCB1 function. We tested a panel of tyrosine kinase inhibitors for the ability to sensitize resistant ABCB1-overexpressing ovarian cancer cell lines to paclitaxel. We observed synergy when we combined poziotinib or lapatinib with paclitaxel in resistant TOV-21G and OVCAR3 cells. Silencing ABCB1 expression in paclitaxel-resistant TOV-21G and OVCAR3 cells reduced paclitaxel IC50 by 20.7 and 6.2-fold, respectively. Furthermore, we demonstrated direct inhibition of paclitaxel-induced ABCB1 transporter activity by both lapatinib and poziotinib. In conclusion, lapatinib and poziotinib combined with paclitaxel synergizes to inhibit the proliferation of ABCB1-overexpressing ovarian cancer cells in vitro. The addition of FDA-approved lapatinib to second-line paclitaxel therapy is a promising strategy for patients with recurrent ovarian cancer.
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Affiliation(s)
- J. Robert McCorkle
- Markey Cancer Center, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Justin W. Gorski
- Markey Cancer Center, College of Medicine, University of Kentucky, Lexington, KY, United States of America
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Jinpeng Liu
- Markey Cancer Center, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - McKayla B. Riggs
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Anthony B. McDowell
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Nan Lin
- College of Pharmacy, University of Kentucky, Lexington, KY, United States of America
| | - Chi Wang
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, United States of America
| | - Frederick R. Ueland
- Markey Cancer Center, College of Medicine, University of Kentucky, Lexington, KY, United States of America
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Jill M. Kolesar
- Markey Cancer Center, College of Medicine, University of Kentucky, Lexington, KY, United States of America
- College of Pharmacy, University of Kentucky, Lexington, KY, United States of America
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Yang H, Zhang K, Liu Z, Wang T, Shi F, Su J, Zhang J, Liu J, Dai L. Clinical analysis of conformal and intensity-modulated radiotherapy in patients with recurrent ovarian cancer. Sci Rep 2020; 10:17172. [PMID: 33057094 PMCID: PMC7560837 DOI: 10.1038/s41598-020-74356-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 09/23/2020] [Indexed: 11/09/2022] Open
Abstract
We aimed to provide evidence for radiotherapy treatment regimens in patients with clinically recurrent ovarian cancer. We analyzed the survival and prognostic factors in 43 patients who were treated for recurrent ovarian cancer at 58 tumor sites using three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) during January 2006-December 2017. t years 1, 2, and 3, overall survival (OS) rate was 82.4%, 68.4%, and 57.9%; local control (LC) rate was 100%, 100% and 80%; recurrence free survival (RFS) rate was 86.8%, 66.6%, and 61.1%; and disease-free survival (DFS) rate was 79.7%, 56.7%, and 46.8%, respectively. The radiotherapy technique was determined to be an independent prognostic factor for survival; the survival rate of patients was significantly improved with IMRT compared to 3D-CRT (P = 0.035). Radiotherapy dose was an independent prognostic factor; survival rate improved when patients were treated with a radiation dose ≥ 60 Gy as compared to < 60 Gy (P = 0.046). Elective nodal prophylactic radiation therapy (ENRT) did not lead to a significant improvement in survival when compared to involved-field radiation therapy (IFRT). The toxicities of 3D-CRT and IMRT were tolerable. One patient (2.3%) had grade 3 acute gastrointestinal (GI) toxicity, 2 (4.6%) grade 3 late GI toxicity, 5 (11.6%) grade 3 hematological toxicity, and 2 (4.6%) had grade 4 hematological toxicity. IMRT improved LC and OS in patients with recurrent ovarian cancer after surgery and multiple chemotherapy; toxicities were tolerable. The IMRT technique and radiotherapy dose of ≥ 60 Gy had independent prognostic significance for the survival of such patients.
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Affiliation(s)
- Hua Yang
- Department of Radiotherapy, Xijing Hospital of Air Force Military Medical University (the Fourth Military Medical University), Xi'an, Shaan'xi, China
| | - Kaishuo Zhang
- Department of Radiotherapy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan'xi, China
| | - Zi Liu
- Department of Radiotherapy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan'xi, China.
| | - Tao Wang
- Department of Radiotherapy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan'xi, China
| | - Fan Shi
- Department of Radiotherapy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan'xi, China
| | - Jin Su
- Department of Radiotherapy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan'xi, China
| | - Jintao Zhang
- Department of Radiotherapy, Xi'an Gao Xin Hospital, Xi'an, Shaan'xi, China
| | - Juanyue Liu
- Department of Radiotherapy, Xi'an Gao Xin Hospital, Xi'an, Shaan'xi, China
| | - Li Dai
- Department of Radiotherapy, Xi'an Gao Xin Hospital, Xi'an, Shaan'xi, China
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Mancari R, Cutillo G, Bruno V, Vincenzoni C, Mancini E, Baiocco E, Bruni S, Vocaturo G, Chiofalo B, Vizza E. Development of new medical treatment for epithelial ovarian cancer recurrence. Gland Surg 2020; 9:1149-1163. [PMID: 32953630 PMCID: PMC7475356 DOI: 10.21037/gs-20-413] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 07/01/2020] [Indexed: 02/05/2023]
Abstract
Epithelial ovarian cancer (EOC) is the scariest gynaecological cancer. Many advances have been done with evolving knowledge, leading to the introduction of new drugs, most in maintenance setting. The antiangiogenic Bevacizumab and the three approved PARP-inhibitors-olaparib, niraparib and rucaparib-are gradually improving PFS of patients with EOC, with initial effects on OS too. But recurrence is still a heavy sentence and lethality continues to be high. Ovarian cancer is a complex disease, with different clinical presentation, histological aspect, and molecular expression, leading to disappointing results, when using a single drug. Implementation of biobanking and analysis of patients' tumour samples, before starting a treatment, could be a promising way to better understand molecular aspects of this disease, to identify markers predictive of response and to allow a better use of experimental drugs, as immunomodulators, targeted therapies, and combinations of these, to fight tumour growth and clinical progression. We reviewed the literature on the updated treatments for recurrent ovarian cancer, summarizing all the available drugs and combinations to treat patients with this diagnosis, and focusing the attention on the new approved molecules and the contemporary Clinical Trials, investigating new target therapies and new associations.
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Affiliation(s)
- Rosanna Mancari
- Department of Experimental Clinical Oncology, Gynecologic Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Cutillo
- Department of Experimental Clinical Oncology, Gynecologic Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Valentina Bruno
- Department of Experimental Clinical Oncology, Gynecologic Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Cristina Vincenzoni
- Department of Experimental Clinical Oncology, Gynecologic Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Emanuela Mancini
- Department of Experimental Clinical Oncology, Gynecologic Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Ermelinda Baiocco
- Department of Experimental Clinical Oncology, Gynecologic Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Simone Bruni
- Division of Obstetrics and Gynecology, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Giuseppe Vocaturo
- Department of Experimental Clinical Oncology, Gynecologic Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Benito Chiofalo
- Department of Experimental Clinical Oncology, Gynecologic Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Enrico Vizza
- Department of Experimental Clinical Oncology, Gynecologic Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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6
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Chen WC, Huang HJ, Chang TC, Chou HH. Dose-dense chemotherapy with weekly paclitaxel and 3-weekly carboplatin for recurrent ovarian cancer. Taiwan J Obstet Gynecol 2020; 59:21-27. [PMID: 32039795 DOI: 10.1016/j.tjog.2019.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2019] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To analyze the response to dose-dense chemotherapy of weekly paclitaxel and 3-weekly carboplatin in recurrent ovarian cancer, and to report results of literature review. MATERIALS AND METHODS Patients accepted weekly paclitaxel 80 mg/m2 on day 1, 8, 15 and carboplatin on day1 at area under curve (AUC) 6 every 21 days were reviewed for the response rate, progression-free survival, overall survival, and toxicity during January 2012 to April 2016 in Chang Gung Memorial Hospital at Linkou, Taiwan. RESULTS Sixteen patients with recurrent ovarian cancer, including 1 platinum-resistant, 7 partially platinum-sensitive, and 8 platinum-sensitive, accepted a median of 6 cycles of chemotherapy (range 3-10). The overall response rate (ORR) and complete response (CR) rate were 93.8%, and 62.5%, respectively. The median PFS of all patients were 10.9 months (range 4.3-40.5). The median time to response (TTR) was 29.0 days (range 19.6-38.4). The median disease-free survival (DFS) after CR was 5.6 months (range 1.2-34.2). Grade 3 at least toxicity included anemia (6.3%), neutropenia (50%), and thrombocytopenia (18.8%). Twenty-nine articles on phase I, II, III, or retrospective studies of dose-dense chemotherapy with weekly paclitaxel were reviewed. CONCLUSION This is the first report using Japanese Gynecologic Oncology Group 3016 protocol, weekly paclitaxel and 3-weely carboplatin, on recurrent ovarian cancer. The current study showed high ORR and CR with tolerable toxicities. Our study suggested dose-dense chemotherapy with paclitaxel, especially combining carboplatin created high efficacy probably by anti-angiogenesis. However, consolidation or maintenance therapy is needed to prolong DFS.
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Affiliation(s)
- Wei-Chun Chen
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taiwan; Chang Gung University, College of Medicine, Taiwan
| | - Huei-Jean Huang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taiwan; Chang Gung University, College of Medicine, Taiwan
| | - Ting-Chang Chang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taiwan; Chang Gung University, College of Medicine, Taiwan
| | - Hung-Hsueh Chou
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taiwan; Chang Gung University, College of Medicine, Taiwan.
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7
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Affiliation(s)
- Debra L Richardson
- Section of Gynecologic Oncology, Stephenson Cancer Center, University of Oklahoma, Oklahoma City
| | | | - Michael W Sill
- NRG Oncology Statistics & Data Management Center, Roswell Park Cancer Institute, Buffalo, New York
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8
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Luvero D, Plotti F, Aloisia A, Montera R, Terranova C, Carlo De Cicco Nardone, Scaletta G, Lopez S, Miranda A, Capriglione S, Gatti A, Pierluigi Benedetti Panici, Angioli R. Ovarian cancer relapse: From the latest scientific evidence to the best practice. Crit Rev Oncol Hematol 2019; 140:28-38. [PMID: 31176270 DOI: 10.1016/j.critrevonc.2019.05.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 03/17/2019] [Accepted: 05/23/2019] [Indexed: 01/10/2023] Open
Abstract
Ovarian cancer (OC) is the fifth most common cause of cancer death in women worldwide. Despite treatment options have continued to improve in recent years, the recurrence rate is still high; in fact around 80% of patients relapses within 18 months. Recently, the scientific landscape is agree in asserting that the ovarian cancer is not a single disease but the outcome of patients depends from the molecular and biological characterization of tumor tissue. In this scenario, molecular targeted therapy given alone or in combination with chemotherapy is showing significant results. We review the different options for the treatment of ovarian cancer recurrence, including the role of surgery, in order to try outlining a possible treatment algorithm evaluating the recent scientific literature and the most important trials.
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Affiliation(s)
- Daniela Luvero
- University Campus Bio Medico of Rome, Department of Obstetrics and Gynecology, Via Álvaro del Portillo, 200, 00128 Rome, Italy.
| | - Francesco Plotti
- University Campus Bio Medico of Rome, Department of Obstetrics and Gynecology, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Alessia Aloisia
- University Campus Bio Medico of Rome, Department of Obstetrics and Gynecology, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Roberto Montera
- University Campus Bio Medico of Rome, Department of Obstetrics and Gynecology, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Corrado Terranova
- University Campus Bio Medico of Rome, Department of Obstetrics and Gynecology, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Carlo De Cicco Nardone
- University Campus Bio Medico of Rome, Department of Obstetrics and Gynecology, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Giuseppe Scaletta
- Unit of Gynecologic Oncology, Department of Women's and Children's Health. A. Gemelli University Polyclinic Foundation Rome, Italy
| | - Salvatore Lopez
- University Campus Bio Medico of Rome, Department of Obstetrics and Gynecology, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Andrea Miranda
- University Campus Bio Medico of Rome, Department of Obstetrics and Gynecology, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Stella Capriglione
- University Campus Bio Medico of Rome, Department of Obstetrics and Gynecology, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Alessandra Gatti
- University Campus Bio Medico of Rome, Department of Obstetrics and Gynecology, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Pierluigi Benedetti Panici
- University of Rome "Sapienza", Department of Gynecological-Obstetric Sciences and Urological Sciences, Umberto I Hospital, Rome, Italy
| | - Roberto Angioli
- University Campus Bio Medico of Rome, Department of Obstetrics and Gynecology, Via Álvaro del Portillo, 200, 00128 Rome, Italy
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Stordal BK, Kalachand R, Hall N. Taxane monotherapy regimens for the treatment of recurrent epithelial ovarian cancer. Hippokratia 2018. [DOI: 10.1002/14651858.cd008766.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Britta K Stordal
- Middlesex University; Department of Natural Sciences; The Burroughs Hendon London UK NW4 4BT
| | - Roshni Kalachand
- Beaumont Hospital and Royal College of Surgeons in Ireland; Department of Medical Oncology; Beaumont Road Dublin 9 Ireland
| | - Neville Hall
- Middlesex University; Department of Natural Sciences; The Burroughs Hendon London UK NW4 4BT
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10
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Oza A, Kaye S, Van Tornout J, Sessa C, Gore M, Naumann RW, Hirte H, Colombo N, Chen J, Gorla S, Poondru S, Singh M, Steinberg J, Yuen G, Banerjee S. Phase 2 study evaluating intermittent and continuous linsitinib and weekly paclitaxel in patients with recurrent platinum resistant ovarian epithelial cancer. Gynecol Oncol 2018; 149:275-282. [PMID: 29454514 DOI: 10.1016/j.ygyno.2018.01.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/18/2018] [Accepted: 01/19/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Linsitinib, an oral, dual inhibitor of insulin-like growth factor-1 receptor and insulin receptor, in combination with weekly paclitaxel, may improve clinical outcomes compared with paclitaxel alone in patients with refractory or platinum-resistant ovarian cancer. PATIENTS AND METHODS This open-label phase 1/2 clinical trial (NCT00889382) randomized patients with refractory or platinum-resistant ovarian cancer (1:1:1) to receive either oral intermittent linsitinib (600mg once daily on Days 1-3 per week) combined with paclitaxel (80mg/m2 on Days 1, 8, and 15; Arm A) or continuous linsitinib (150mg twice daily) in combination with paclitaxel (Arm B), or paclitaxel alone (Arm C). Primary endpoint was progression-free survival (PFS); secondary endpoints included overall survival (OS), overall response rate (ORR), disease control rate (DCR), and safety/tolerability. RESULTS A total of 152 women were randomized to treatment (n=51 Arm A; n=51 Arm B, n=50 Arm C). In combination with paclitaxel, neither intermittent linsitinib (median PFS 2.8months; 95% confidence interval [CI]:2.5-4.4) nor continuous linsitinib (median PFS 4.2months; 95% CI:2.8-5.1) improved PFS over weekly paclitaxel alone (median PFS 5.6months; 95% CI:3.2-6.9). No improvement in ORR, DCR, or OS in either linsitinib dosing schedule was observed compared with paclitaxel alone. Adverse event (AE) rates, including all-grade and grade 3/4 treatment-related AEs, and treatment-related AEs leading to discontinuation, were higher among patients receiving intermittent linsitinib compared with the other treatment arms. CONCLUSION Addition of intermittent or continuous linsitinib with paclitaxel did not improve outcomes in patients with platinum-resistant/refractory ovarian cancer compared with paclitaxel alone.
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Affiliation(s)
- Amit Oza
- Princess Margaret Cancer Centre, University of Toronto, ON, Canada.
| | - Stanley Kaye
- The Royal Marsden and The Institute of Cancer Research, London, UK
| | | | - Cristiana Sessa
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Martin Gore
- The Royal Marsden and The Institute of Cancer Research, London, UK
| | - R Wendel Naumann
- Levine Cancer Institute at Carolinas Healthcare System, Charlotte, NC, USA
| | - Hal Hirte
- Juravinski Cancer Centre, Hamilton, ON, Canada
| | - Nicoletta Colombo
- European Institute of Oncology and University of Milan-Bicocca, Milan, Italy
| | - Jihong Chen
- Astellas Pharma Global Development, Northbrook, IL, USA
| | - Seema Gorla
- Astellas Pharma Global Development, Northbrook, IL, USA
| | | | | | | | - Geoff Yuen
- Astellas Pharma Global Development, Northbrook, IL, USA
| | - Susana Banerjee
- The Royal Marsden and The Institute of Cancer Research, London, UK.
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11
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Tomao F, Marchetti C, Romito A, Di Pinto A, Di Donato V, Capri O, Palaia I, Monti M, Muzii L, Benedetti Panici P. Overcoming platinum resistance in ovarian cancer treatment: from clinical practice to emerging chemical therapies. Expert Opin Pharmacother 2017; 18:1443-1455. [PMID: 28521614 DOI: 10.1080/14656566.2017.1328055] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The objective of this review is to summarize results from clinical trials that tested cytotoxic drugs and target strategies for the treatment of platinum resistant (PR) recurrent ovarian cancer (ROC) with particular attention to Phase III and ongoing trials. Areas covered: Since platinum free interval (PFI) represents the most important predictive factor for response to platinum re-treatment in ROC, non-platinum regimens are conventionally considered the most appropriate approaches. Impressive progress has been made in recent decades, resulting in the identification of most effective cytotoxic agents and in the development of new target strategies. However, the efficacy of most of these drugs for the treatment of PR disease is still limited. Expert opinion: The most favorable benefit for the treatment of PR disease, has been described by the AURELIA trial that showed a 3.3 months increase in progression free survival (PFS) when bevacizumab was combined with non-platinum single agent chemotherapy in bevacizumab-naïve patients. Nevertheless, the use of novel agents is associated to important costs for just little gains in survival. Thus, in our opinion the economic evaluation, such as the incorporation of quality of life into the clinical studies is crucial for the development of future trials for PR-ROC.
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Affiliation(s)
- Federica Tomao
- a Department of Gynaecology and Obstetrics , "Sapienza" University of Rome , Rome , Italy
| | - Claudia Marchetti
- a Department of Gynaecology and Obstetrics , "Sapienza" University of Rome , Rome , Italy
| | - Alessia Romito
- a Department of Gynaecology and Obstetrics , "Sapienza" University of Rome , Rome , Italy
| | - Anna Di Pinto
- a Department of Gynaecology and Obstetrics , "Sapienza" University of Rome , Rome , Italy
| | - Violante Di Donato
- a Department of Gynaecology and Obstetrics , "Sapienza" University of Rome , Rome , Italy
| | - Oriana Capri
- a Department of Gynaecology and Obstetrics , "Sapienza" University of Rome , Rome , Italy
| | - Innocenza Palaia
- a Department of Gynaecology and Obstetrics , "Sapienza" University of Rome , Rome , Italy
| | - Marco Monti
- a Department of Gynaecology and Obstetrics , "Sapienza" University of Rome , Rome , Italy
| | - Ludovico Muzii
- a Department of Gynaecology and Obstetrics , "Sapienza" University of Rome , Rome , Italy
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Wang HY, Yao ZH, Tang H, Zhao Y, Zhang XS, Yao SN, Yang SJ, Liu YY. Weekly nanoparticle albumin-bound paclitaxel in combination with cisplatin versus weekly solvent-based paclitaxel plus cisplatin as first-line therapy in Chinese patients with advanced esophageal squamous cell carcinoma. Onco Targets Ther 2016; 9:5663-5669. [PMID: 27713635 PMCID: PMC5045233 DOI: 10.2147/ott.s108580] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE More effective regimens for advanced esophageal squamous cell carcinoma (ESCC) are urgently needed. Therefore, a retrospective study concerning the efficacy and safety of nanoparticle albumin-bound paclitaxel plus cisplatin (nab-TP) versus solvent-based paclitaxel plus cisplatin (sb-TP) as a first-line therapy was conducted in Chinese patients with advanced ESCC. METHODS From June 2009 to June 2015, 32 patients were treated with nab-paclitaxel (125 mg/m2) on the first and eighth days (30 minutes infusion) and cisplatin (75 mg/m2) on the second day every 21 days (nab-TP arm). Also, 43 patients were treated with solvent-based paclitaxel (80 mg/m2) intravenously on the first and eighth days and the same dose of cisplatin (sb-TP arm). The two groups were compared in terms of objective response rate (ORR), disease control rate, progression-free survival (PFS), overall survival (OS), and safety profile. OS and PFS were estimated using Kaplan-Meier methods to determine associations between chemotherapy regimens and survival outcomes. RESULTS Nab-TP demonstrated a higher ORR (50% vs 30%; P=0.082) and disease control rate (81% vs 65%; P=0.124) than sb-TP. Median OS was similar for nab-TP and sb-TP (12.5 vs 10.7 months; P=0.269). However, nab-TP resulted in a longer median PFS (6.1 months [95% confidence interval: 5.3-6.9]) than sb-TP (5.0 months [95% confidence interval: 4.4-5.6]) (P=0.029). The most common adverse events included anemia, leukopenia, neutropenia, febrile neutropenia, and thrombocytopenia in both the groups and no statistically significant differences were observed between the groups. With statistically significant differences, significantly less grade ≥3 peripheral neuropathy, arthralgia, and myalgia occurred in the nab-TP arm (all P<0.05). Dose reduction, treatment delays, and second-line therapy were similar between the two regimens. There were no treatment-related deaths in either group. CONCLUSION Nab-paclitaxel plus cisplatin is found to be an effective and tolerable option for advanced ESCC in the People's Republic of China.
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Affiliation(s)
- Hai-Ying Wang
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Zhi-Hua Yao
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Hong Tang
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Yan Zhao
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Xiao-San Zhang
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Shu-Na Yao
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Shu-Jun Yang
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Yan-Yan Liu
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
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