Original Article Obstet Gynecol Sci 2017;60(5):433-439 https://doi.org/10.5468/ogs.2017.60.5.433 pISSN 2287-8572 · eISSN 2287-8580
The efficacy and safety of pegylated liposomal doxorubicin monotherapy and combination therapy with carboplatin in Korean patients with recurrent ovarian, fallopian tube, or primary peritoneal cancer: a single-institution experience Young-Jae Lee, Yong-Man Kim, Shin-Wha Lee, Jeong-Yeol Park, Dae-Yeon Kim, Dae-Shik Suh, Jong-Hyeok Kim, Young-Tak Kim, Joo-Hyun Nam Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Objective This study aimed to evaluate the efficacy and safety of pegylated liposomal doxorubicin (PLD) with or without carboplatin in Korean patients with recurrent ovarian cancer (ROC), fallopian tube, or primary peritoneal cancer. Methods This retrospective study included 52 patients with ROC, fallopian tube, or primary peritoneal cancer who received PLD (50 mg/m2) between 1st December 2014 and 31th July 2016. Results The mean number of chemotherapy cycles was 3.8 (range, 2 to 9) in the PLD monotherapy group and 7 (range, 2 to 13) in the PLD combined with carboplatin (PLD-C) group. In overall response rates and clinical beneficial rates, PLD monotherapy group shows 5.0% and 17.5%, and PLD-C group shows 33.3% and 75.0%. The mean progressionfree survival (PFS) was 5 and 13 months in the PLD monotherapy and PLD-C groups, respectively. At 6 months after treatment initiation, absence of disease progression was confirmed in 6 (15%) and 10 (83.3%) patients in the PLD monotherapy and PLD-C groups. Hematological adverse events (e.g., neutropenia and thrombocytopenia) were more common in the PLD-C group (P 20
9 (75.0)
27 (67.5)
1,000
1 (8.3)
9 (22.5)
CA-125 level (U/mL)
0.391
Treatment-free interval (mon)
0.002 10.7
3.7
6
0.230 0.858
Unknown
Mean
P -value
12 (100.0)
8 (20.0)
No. of previous chemotherapy regimens
0.001
≤3
12 (100)
21 (52.5)
>3
0 (0)
19 (47.5)
PLD, pegylated liposomal doxorubicin; PLD-C, pegylated liposomal doxorubicin combined with carboplatin; FIGO, International Federation of Gynecology and Obstetrics; CA-125, cancer antigen 125.
www.ogscience.org
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Table 2. Response of subgroups according to the chemotherapy regimens
1.0
Variables
PLD-C (n=12)
Single PLD (n=40)
Measurable disease (RECIST 1.1) CR
2 (16.7)
1 (2.5)
PR
2 (16.7)
0 (0)
SD
5 (41.7)
8 (20.0)
PD
3 (25.0)
31 (77.5)
0.8
0.6 PLD-C (mean PFS, 13 mo)
0.4
0.2
PLD monotherapy (mean PFS, 5 mo)
0.0
CA-125 Response
9 (75.0)
8 (20.0)
No response
3 (25.0)
32 (80.0)
CR
2 (16.7)
1 (2.5)
PR
2 (16.7)
1 (2.5)
SD
5 (41.7)
5 (12.5)
PD
Overall response (GCIG criteria)
3 (25.0)
33 (82.5)
Response rate (CR + PR)
4 (33.3)
2 (5.0)
CBR (CR + PR + SD)
9 (75.0)
7 (17.5)
Death
1 (8.3)
27 (67.5)
PLD, pegylated liposomal doxorubicin; PLD-C, pegylated liposomal doxorubicin combined with carboplatin; RECIST, Response Evaluation Criteria in Solid Tumors; CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease; CA-125, cancer antigen 125; GCIG, Gynecologic Cancer Intergroup; CBR, clinical benefit rate.
regimen administered are summarized in Table 2. All patients were eligible for response evaluation. The mean number of chemotherapy cycles administered was 3.8 (range, 2 to 9) in the PLD monotherapy group and 7 (range, 2 to 13) in the PLD-C group. ORR and CBR were 5.0% and 17.5% in the PLD monotherapy group and 33.3% and 75.0% in the PLD-C group, respectively. Kaplan-Meier curves for PFS in each group are presented in Fig. 1. The mean PFS was 5 months in the PLD monotherapy group and 13 months in the PLD-C group. At 6 months after treatment initiation, no disease progression was noted in 6 (15%) patients of the PLD monotherapy group and 10 (83.3%) patients of the PLD-C group. Moreover, 27 (67.5%) patients of the PLD monotherapy group and one (8.3%) patient of the PLD-C group died during the treatment period. Adverse events according to chemotherapy regimens are summarized in Table 3. Hematological adverse events such as neutropenia and thrombocytopenia were more common 436
Proportion not progressing
No. of patients (%)
0
5
10 Time after treatment (months)
15
20
Fig. 1. PFS in each group. PFS, progression-free survival; PLD, pegylated liposomal doxorubicin; PLD-C, pegylated liposomal doxorubicin combined with carboplatin.
in the PLD-C group (P
The efficacy and safety of pegylated liposomal doxorubicin monotherapy and combination therapy with carboplatin in Korean patients with recurrent ovarian, fallopian tube, or primary peritoneal cancer: a single-institution experience Young-Jae Lee, Yong-Man Kim, Shin-Wha Lee, Jeong-Yeol Park, Dae-Yeon Kim, Dae-Shik Suh, Jong-Hyeok Kim, Young-Tak Kim, Joo-Hyun Nam Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Objective This study aimed to evaluate the efficacy and safety of pegylated liposomal doxorubicin (PLD) with or without carboplatin in Korean patients with recurrent ovarian cancer (ROC), fallopian tube, or primary peritoneal cancer. Methods This retrospective study included 52 patients with ROC, fallopian tube, or primary peritoneal cancer who received PLD (50 mg/m2) between 1st December 2014 and 31th July 2016. Results The mean number of chemotherapy cycles was 3.8 (range, 2 to 9) in the PLD monotherapy group and 7 (range, 2 to 13) in the PLD combined with carboplatin (PLD-C) group. In overall response rates and clinical beneficial rates, PLD monotherapy group shows 5.0% and 17.5%, and PLD-C group shows 33.3% and 75.0%. The mean progressionfree survival (PFS) was 5 and 13 months in the PLD monotherapy and PLD-C groups, respectively. At 6 months after treatment initiation, absence of disease progression was confirmed in 6 (15%) and 10 (83.3%) patients in the PLD monotherapy and PLD-C groups. Hematological adverse events (e.g., neutropenia and thrombocytopenia) were more common in the PLD-C group (P 20
9 (75.0)
27 (67.5)
1,000
1 (8.3)
9 (22.5)
CA-125 level (U/mL)
0.391
Treatment-free interval (mon)
0.002 10.7
3.7
6
0.230 0.858
Unknown
Mean
P -value
12 (100.0)
8 (20.0)
No. of previous chemotherapy regimens
0.001
≤3
12 (100)
21 (52.5)
>3
0 (0)
19 (47.5)
PLD, pegylated liposomal doxorubicin; PLD-C, pegylated liposomal doxorubicin combined with carboplatin; FIGO, International Federation of Gynecology and Obstetrics; CA-125, cancer antigen 125.
www.ogscience.org
435
Vol. 60, No. 5, 2017
Table 2. Response of subgroups according to the chemotherapy regimens
1.0
Variables
PLD-C (n=12)
Single PLD (n=40)
Measurable disease (RECIST 1.1) CR
2 (16.7)
1 (2.5)
PR
2 (16.7)
0 (0)
SD
5 (41.7)
8 (20.0)
PD
3 (25.0)
31 (77.5)
0.8
0.6 PLD-C (mean PFS, 13 mo)
0.4
0.2
PLD monotherapy (mean PFS, 5 mo)
0.0
CA-125 Response
9 (75.0)
8 (20.0)
No response
3 (25.0)
32 (80.0)
CR
2 (16.7)
1 (2.5)
PR
2 (16.7)
1 (2.5)
SD
5 (41.7)
5 (12.5)
PD
Overall response (GCIG criteria)
3 (25.0)
33 (82.5)
Response rate (CR + PR)
4 (33.3)
2 (5.0)
CBR (CR + PR + SD)
9 (75.0)
7 (17.5)
Death
1 (8.3)
27 (67.5)
PLD, pegylated liposomal doxorubicin; PLD-C, pegylated liposomal doxorubicin combined with carboplatin; RECIST, Response Evaluation Criteria in Solid Tumors; CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease; CA-125, cancer antigen 125; GCIG, Gynecologic Cancer Intergroup; CBR, clinical benefit rate.
regimen administered are summarized in Table 2. All patients were eligible for response evaluation. The mean number of chemotherapy cycles administered was 3.8 (range, 2 to 9) in the PLD monotherapy group and 7 (range, 2 to 13) in the PLD-C group. ORR and CBR were 5.0% and 17.5% in the PLD monotherapy group and 33.3% and 75.0% in the PLD-C group, respectively. Kaplan-Meier curves for PFS in each group are presented in Fig. 1. The mean PFS was 5 months in the PLD monotherapy group and 13 months in the PLD-C group. At 6 months after treatment initiation, no disease progression was noted in 6 (15%) patients of the PLD monotherapy group and 10 (83.3%) patients of the PLD-C group. Moreover, 27 (67.5%) patients of the PLD monotherapy group and one (8.3%) patient of the PLD-C group died during the treatment period. Adverse events according to chemotherapy regimens are summarized in Table 3. Hematological adverse events such as neutropenia and thrombocytopenia were more common 436
Proportion not progressing
No. of patients (%)
0
5
10 Time after treatment (months)
15
20
Fig. 1. PFS in each group. PFS, progression-free survival; PLD, pegylated liposomal doxorubicin; PLD-C, pegylated liposomal doxorubicin combined with carboplatin.
in the PLD-C group (P
