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Oral cyclophosphamide in recurrent ovarian cancer
Author(s) -
Handolias Despina,
Quinn Michael,
Foo Serene,
Mileshkin Linda,
Grant Peter,
Dutu Gaelle,
Rischin Danny
Publication year - 2016
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12074
Subject(s) - cyclophosphamide , medicine , chemotherapy , oncology , ovarian cancer , toxicity , response evaluation criteria in solid tumors , paclitaxel , gastroenterology , cancer , progressive disease , surgery , urology
Aims Cyclophosphamide was widely used as a single agent prior to the advent of platinum‐based regimens for epithelial ovarian cancer, and, in combination with platinum, prior to the adoption of platinum and paclitaxel as standard first‐line therapy. As cyclophosphamide currently has no defined role in ovarian cancer we aimed to assess its activity in women with recurrent disease. Methods A retrospective review was conducted of patients from three centers in M elbourne, A ustralia who had received oral cyclophosphamide treatment for recurrent ovarian cancer. The primary end‐point was response rate to oral cyclophosphamide (150 mg p.o. day 1–14) based on Gynecologic Cancer InterGroup ( GCIG) CA125 and/or Response Evaluation Criteria in Solid Tumors ( RECIST ) criteria. Secondary end‐points included overall and progression‐free survival and toxicity. Results In all, 26 patients were identified and 23 patients were evaluable for response. The median number of prior chemotherapy regimens was three (range 1–6). The response rate to oral cyclophosphamide was 44% with 10 of the 23 patients achieving a partial response ( PR ) based on GCIG ( CA125 ) criteria. The median number of cycles received was three (range 1–16). Cyclophosphamide showed activity both in patients with platinum‐sensitive (seven of 13 PR ) and resistant or refractory disease (three of 10 PR ). There was no grade 3 or 4 toxicity but two patients ceased cyclophosphamide due to less severe non‐hematological toxicity. Conclusion Single agent oral cyclophosphamide is active and well tolerated in recurrent ovarian cancer. Further investigation of oral cyclophosphamide in patients with platinum‐sensitive and platinum‐resistant disease is warranted.