Usefulness of third-line chemotherapy for women with recurrent ovarian, fallopian tube, and primary peritoneal cancer who receive platinum/taxane regimens as first-line therapy

J Cancer Res Clin Oncol. 2009 Apr;135(4):551-7. doi: 10.1007/s00432-008-0488-x. Epub 2008 Oct 1.

Abstract

Background: Limited information is available regarding the usefulness of third-line chemotherapy for recurrent ovarian, fallopian tube, and primary peritoneal cancer treated with platinum-taxane regimens as first-line therapy.

Patients and methods: We retrospectively reviewed the medical records of women with ovarian, fallopian tube, and primary peritoneal cancer who were treated at the National Cancer Center Hospital between 1999 and 2005 to investigate the relations of clinicopathological factors to important clinical endpoints such as the response rate (RR), time to progression (TTP) and overall survival (OS) after third-line chemotherapy.

Results: A total of 172 patients received first-line platinum/taxane regimens during the study period, among whom 111 had disease progression after first-line chemotherapy. Eighty-one of these 111 patients received second-line chemotherapy, and 73 had disease progression. Fifty-four of the 73 patients with disease progression received third-line chemotherapy. The RR to third-line chemotherapy was 40.7% (95% CI, 27.6-53.8%). The median TTP was 4.4 months (range 0-19.5 months), and the median OS was 10.4 months (range 1.5-44.3 months). Performance status (PS) and primary drug-free interval (DFI) were independent predictive factors for the RR to third-line chemotherapy (P = 0.04 and P = 0.009). PS and primary DFI were also independent predictive factors for TTP and OS on multivariate analysis (P = 0.006, P = 0.005 and P = 0.01, P = 0.004, respectively).

Conclusions: PS and primary DFI are useful predictors of the response to third-line chemotherapy in women with recurrent ovarian, fallopian tube, and primary peritoneal cancer. In this setting, however, both of these variables are subject to several well-established potential biases and limitations; further prospective studies are thus needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bridged-Ring Compounds / administration & dosage
  • Bridged-Ring Compounds / therapeutic use*
  • CA-125 Antigen / blood
  • Disease Progression
  • Fallopian Tube Neoplasms / drug therapy*
  • Fallopian Tube Neoplasms / pathology
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Staging
  • Neoplasms, Second Primary / drug therapy*
  • Neoplasms, Second Primary / pathology
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / pathology
  • Peritoneal Neoplasms / drug therapy*
  • Peritoneal Neoplasms / pathology
  • Platinum Compounds / administration & dosage
  • Platinum Compounds / therapeutic use*
  • Retrospective Studies
  • Survival Analysis
  • Taxoids / administration & dosage
  • Taxoids / therapeutic use*

Substances

  • Bridged-Ring Compounds
  • CA-125 Antigen
  • Platinum Compounds
  • Taxoids
  • taxane