DOI QR코드

DOI QR Code

Phase II Clinical Study on the GEMOX Regimen as Second-line Therapy for Advanced Ovarian Cancer

  • Yuan, Shao-Fei (Department of Oncology & Chemoradiotherapy of Rui'an People Hospital) ;
  • Zhang, Lian-Ping (Department of Urology, Second Xiangya Hospital, Central South University) ;
  • Zhu, Lin-Jia (Department of Oncology & Chemoradiotherapy of Rui'an People Hospital) ;
  • Chen, Wen-Jun (Department of Oncology & Chemoradiotherapy of Rui'an People Hospital) ;
  • Zheng, Wei-E (Department of Oncology & Chemoradiotherapy of Rui'an People Hospital) ;
  • Xiong, Jian-Ping (Cancer Center, First Affiliated Hospital of Nanchang Universituy)
  • Published : 2013.06.30

Abstract

Aim: To investigate the effectiveness and adverse effects of gemcitabine by fixed-dose rate infusion plus oxaliplatin (GEMOX regimen) as second-line therapy for advanced ovarian cancer. Methods: 64 patients with advanced ovarian cancer were divided into an experimental group (44 cases) and a control group (20 cases). The experimental group was treated with continuous intravenous infusion of gemcitabine at 1000 $mg/m^2$ with a fixed-dose rate of 10 $mg/m^2/min$, on days 1 and 8 and oxaliplatin at 100 $mg/m^2$ on day 1, IVGTT, repeated every 3 weeks. The control group was treated with intravenous infusion of gemcitabine at 1000 $mg/m^2$ within 30 min on days 1 and and oxaliplatin at 100 $mg/m^2$ on day 1, IVGTT, again repeated every 3 weeks. CT scans or MRI were used for review every 1-2 cycles. Results: The effective rate in the experimental group was significantly high than control group (43.2% vs 35.0%; P < 0.05), with no obvious difference of hematologic or non-hematologic toxicity between the two groups (P > 0.05). Conclusion: GEMOX regimen is very effective to treat advanced ovarian cancer, with low toxicity, good tolerance and improved life quality in patients.

Keywords

Ovarian cancer;gemcitabine;oxaliplatin

References

  1. A Boere I, EL van der Burg M (2012). Review of dose-intense platinum and/or paclitaxel containing chemotherapy in advanced and recurrent epithelial ovarian cancer. Curr Pharm Des, 18, 3741-53. https://doi.org/10.2174/138161212802002634
  2. Deraco M, Virzi S, Iusco D, et al (2012). Secondary cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent epithelial ovarian cancer: A multi institutional study. BJOG: An International Journal of Obstetrics & Gynaecology, 119, 800-9. https://doi.org/10.1111/j.1471-0528.2011.03207.x
  3. Frenel JS, Leux C, Pouplin L, et al (2011). Oxaliplatin based hyperthermic intraperitoneal chemotherapy in primary or recurrent epithelial ovarian cancer: A pilot study of 31 patients. J Surg Oncol, 103, 10-6. https://doi.org/10.1002/jso.21732
  4. Giuntoli R, Bristow R, Diaz-Montes T, et al (2011). Feasibility of intravenous gemcitabine and an intraperitoneal platinum agent in the treatment of ovarian cancer. J Chemother, 23, 163-7. https://doi.org/10.1179/joc.2011.23.3.163
  5. Gordon AN, Teneriello M, Janicek MF, et al (2011). Phase iii trial of induction gemcitabine or paclitaxel plus carboplatin followed by paclitaxel consolidation in ovarian cancer. Gynecol Oncol, 123, 479-85. https://doi.org/10.1016/j.ygyno.2011.08.018
  6. Hanker L, Loibl S, Burchardi N, et al (2012). The impact of second to sixth line therapy on survival of relapsed ovarian cancer after primary taxane/platinum-based therapy. Ann Oncol, 23, 2605-12. https://doi.org/10.1093/annonc/mds203
  7. Kajiyama H, Shibata K, Suzuki S, et al (2011). Survival impact of adjuvant paclitaxel and carboplatin for early-stage ovarian clear-cell carcinoma with complete surgical staging. Gynecol Obstet Invest, 72, 252-6. https://doi.org/10.1159/000327924
  8. Kim MJ, Jung YW, Seong SJ, et al (2012). Intraoperative intraperitoneal chemotherapy with cisplatin in epithelial ovarian cancer. J Gynecol Oncol, 23, 91-7. https://doi.org/10.3802/jgo.2012.23.2.91
  9. Meier W, du Bois A, Rau J, et al (2012). Randomized phase ii trial of carboplatin and paclitaxel with or without lonafarnib in first-line treatment of epithelial ovarian cancer stage iib-iv. Gynecol Oncol, 126, 236-40. https://doi.org/10.1016/j.ygyno.2012.04.050
  10. Miyoshi Y, Ueda Y, Morimoto A, et al (2011). Salvage chemotherapy for ovarian carcinoma recurring during or after consolidation chemotherapy with paclitaxel. Anticancer Res, 31, 4613-7.
  11. Murgia V, Sorio R, Griso C, et al (2010). Multicenter phase 2 study of combined gemcitabine and epirubicin as second-line treatment for patients with advanced ovarian cancer. Int J Gynecol Cancer, 20, 953-7. https://doi.org/10.1111/IGC.0b013e3181e4a6c1
  12. Palma MD, Lombardi G, Donach ME, et al (2011). Tolerability of pld/oxaliplatin regimen in recurrent ovarian cancer patients with previous fragility to carboplatin/paclitaxel treatment. Am J Clin Oncol, 34, 305. https://doi.org/10.1097/COC.0b013e3181e1cb22
  13. Raspagliesi F, Zanaboni F, Vecchione F, et al (2005). Gemcitabine combined with oxaliplatin (gemox) as secondline chemotherapy in patients with advanced ovarian cancer refractory or resistant to platinum and taxane. Oncology, 67, 376-81.
  14. Rong RS, Jin W, Yu Z, et al (2012). The clinical observation of gemcitabine and oxaliplatin in relapse and metastasis ovarian cancer. Sichuan Med J, 33, 219-20. (In Chinese)
  15. Seliger G, Mueller LP, Kegel T, et al (2009). Phase 2 trial of docetaxel, gemcitabine, and oxaliplatin combination chemotherapy in platinum-and paclitaxel-pretreated epithelial ovarian cancer. Int J Gynecol Cancer, 19, 1446-53. https://doi.org/10.1111/IGC.0b013e3181b62f38
  16. Sherman-Baust CA, Becker KG, Wood Iii WH, et al (2011). Gene expression and pathway analysis of ovarian cancer cells selected for resistance to cisplatin, paclitaxel, or doxorubicin. J Ovarian Res, 4, 21. https://doi.org/10.1186/1757-2215-4-21
  17. Sorbe B, Graflund M, Nygren L, et al (2012). A phase ii study of docetaxel weekly in combination with carboplatin every three weeks as first line chemotherapy in stage iib-iv epithelial ovarian cancer: Neurological toxicity and qualityof-life evaluation. Int J Oncol, 40, 773-81.
  18. Suprasert P, Cheewakriangkrai CManopunya M (2012). Outcome of single agent generic gemcitabine in platinumresistant ovarian cancer, fallopian tube cancer and primary peritoneal adenocarcinoma. Asian Pac J Cancer Prev, 13, 517-20. https://doi.org/10.7314/APJCP.2012.13.2.517
  19. Therasse P, Arbuck SG, Eisenhauer EA, et al (2000). New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst, 92, 205-16. https://doi.org/10.1093/jnci/92.3.205
  20. Wang L, Xie XH, Mai ZF, et al (2009). Effect of gemcitabine and oxaliplatin on recurrent advanced ovarian carcinoma. Journal of Hainan Medical College, 15, 1068-70. (In Chinese)

Cited by

  1. Treatment Outcomes of Gemcitabine in Refractory or Recurrent Epithelial Ovarian Cancer Patients vol.15, pp.13, 2014, https://doi.org/10.7314/APJCP.2014.15.13.5215