Phase II of oral gimatecan in patients with recurrent epithelial ovarian, fallopian tube or peritoneal cancer, previously treated with platinum and taxanes

Background: A prospective phase II study was conducted to evaluate the efficacy and toxicity of oral gimatecan in patients with recurrent epithelial ovarian, fallopian tube or peritoneal cancer

Gynecologic oncology group trials of chemotherapy for metastatic and recurrent cervical cancer

Because only 16% of patients with metastatic cervical cancer are alive 5 years after diagnosis, the Gynecologic Oncology Group (GOG) has carefully designed and conducted many phase II studies to identify promising drugs. Cisplatin has emerged as the most active single agent with overall response rates of 19%. Recent phase III trials have documented response rates of 27% and 39% when cisplatin has been combined with either paclitaxel or topotecan, respectively. The comparison of cisplatin to cisplatin plus topotecan in GOG-179 has yielded the first study to show a statistically significant impact on the overall response rate, median progression-free survival, and median survival, with all outcome measures favoring the two-drug regimen. Despite these encouraging results, however, most of the responses are partial and of short duration. The need for novel combinations and the implementation of active biologic agents is implicit. The accumulated data in this disease setting, as evidenced by the experience of the GOG, are presented in this review

Serum levels of dimeric activin A are not a marker of placental tumors in the course of chemotherapy.

The aim of the present study was to evaluate whether serum activin A levels may represent, in addition to intact human chorionic gonadotrophin, a marker of placental tumors in the course of chemotherapy. Serial determinations of serum levels of activin A were performed in women with hydatidiform mole (n = 2) or choriocarcinoma (n = 3). Serum activin A levels were measured by using a new specific two-site enzyme immunoassay (EIA) able to detect the dimeric, bioactive, form of the protein. Serum hCG concentrations in samples taken after evacuation before starting chemotherapy were greater than in healthy non-pregnant women (p < 0.001) and decreased following chemotherapy. Activin A serum levels in women with trophoblastic disease after evacuation were significantly higher than in healthy non-pregnant women, but chemotherapy did not significantly affect circulating levels. No correlation was found between changes of activin A and total hCG serum concentrations. Measurement of activin A by ELISA in presence of persistent molar tumor does not seem to be of clinical interest in the follow-up of disease, resulting activin A concentrations after chemotherapy in the range of values occurring throughout menstrual cycle. These evidences suggest that hCG determination is still the most valid for follow-up, because only intact hCG could detect the persistence of trophoblast tissue

[Laparoscopic treatment of borderline ovarian tumor: analysis of 54 patients and clinical outcomes]

International audienceOBJECTIVE: The aim of this study is to assess the clinical outcomes of laparoscopic treatment of borderline ovarian tumor (BOT). PATIENTS AND METHODS: Retrospective analysis of 54 patients treated using a laparoscopic approach for a BOT between January 1984 and January 2002. RESULTS: A conservative management was initially performed in 45 patients (83%). Twenty-six patients underwent a reassessment surgery and 7 (27%) of them were upstaged following this procedure. Seven (13%) patients recurred in a remaining ovary following conservative surgery (5 patients) or on the peritoneum (2 patients). Three port-site localizations were observed. None of the patients treated with conservative management had recurrent disease under the form of ovarian carcinoma. Nine spontaneous pregnancies were observed in 6 patients from a group of 19 patients desiring pregnancy. All patients are today alive and disease-free. DISCUSSION AND CONCLUSION: Our study suggests that laparoscopic treatment could be safely performed in young patients with early stage BOT. Such procedure should be further evaluated in patients with BOT and peritoneal implants

Phase I-II and pharmacokinetic study of gemcitabine combined with oxaliplatin in patients with advanced non-small-cell lung cancer and ovarian carcinoma.

BACKGROUND: The aim of this study was to determine the toxicity profile, the recommended dose (RD) and the pharmacokinetic parameters, and to evaluate the antitumor activity of gemcitabine combined with oxaliplatin in patients with advanced non-small-cell lung cancer (NSCLC) and ovarian carcinoma (OC). METHODS: Gemcitabine was administered as a 30-min infusion followed by a 2-h infusion of oxaliplatin, repeated every 2 weeks. Doses of gemcitabine and oxaliplatin ranged from 800 to 1500 and 70 to 100 mg/m(2), respectively. RESULTS: Forty-four patients (26 males, 18 females; median age 55 years) including 35 NSCLC (five platinum pretreated) and nine OC patients (all platinum pretreated) received a total of 355 cycles. All patients were evaluable for toxicity. No dose-limiting toxicity at any dose level occurred during the first two cycles; therefore, the highest dose-level of gemcitabine (1500 mg/m(2)) and oxaliplatin (85 mg/m(2)) was considered as the RD. Hematological toxicity was moderate amongst the 22 patients treated (167 cycles) at that dose level. Thirteen cycles were associated with grade 3-4 non-febrile neutropenia in six patients, and eight cycles with grade 3-4 thrombocytopenia in two patients. Other toxicities were mild to moderate, consisting of asthenia and peripheral neurotoxicity. Four of the 35 patients treated with oxaliplatin 85 mg/m(2) experienced grade 3 neurotoxicity requiring treatment discontinuation at cycle 10. In the range of the doses used, gemcitabine and its main metabolite 2',2'-difluorodeoxyuridine appeared not to be affected by oxaliplatin 70-100 mg/m(2). Of the 44 patients evaluable for activity, 12 NSCLC patients experienced objective responses (one complete and 11 partial responses) and three OC patients showed tumor stabilization lasting for 6 months with a 50% decrease of CA 125 level. Two partial responses (NSCLC) and one tumor stabilization (OC) occurred in platinum-resistant patients. CONCLUSIONS: The combination of gemcitabine and oxaliplatin could be safely administered on an out-patient schedule in patients with advanced NSCLC and OC. The RD was gemcitabine 1500 mg/m(2) and oxaliplatin 85 mg/m(2) every 2 weeks. Promising antitumor activity was reported in patients with NSCLC and platinum-pretreated OC, and thus, deserves further evaluation