Intraperitoneal cisplatin and intravenous paclitaxel in the treatment of epithelial ovarian cancer patients with a positive second look

Sharmila K. Makhija, P. Sabbatini, C. Aghajanian, E. Venkatraman, D. R. Spriggs, R. Barakat

Research output: Contribution to journalArticle

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Abstract

Objective. The aim of this study was to review the role and safety of intraperitoneal (IP) cisplatin and intravenous (IV) paclitaxel in platinum-sensitive epithelial ovarian cancer patients who were found to have small-volume disease (<1 cm) at the time of their second-look procedure. Methods. In a retrospective review, 32 patients with small-volume disease had an IP Bardport catheter placed at the time of second look at Memorial Sloan-Kettering Cancer Center (1995-1998). Patients received IP cisplatin (75 mg/m2) every 3 weeks and either IV paclitaxel (135 mg/m2) every 3 weeks or IV paclitaxel (80 mg/m2) weekly for a maximum of five cycles. Results. Twenty-four (75%) of 32 patients received IP cisplatin/IV paclitaxel every 3 weeks and 8 (25%) received IP cisplatin every 3 weeks with weekly IV paclitaxel. Seven (21.9%) of 32 patients required interruption of treatment secondary to neuropathy. Of these, 4 (15.6%) were changed to another IV chemotherapeutic agent, and 3 (9.3%) required discontinuation of IV paclitaxel only. Two (6%) patients required IP port removal secondary to malfunction and were changed to IV therapy and 1 (3%) requested discontinuation of IP therapy secondary to abdominal pain. Median follow-up was 19 months (mean, 20.1 months; range, 6-36 months). Progression of disease after completion of IP therapy was documented by clinical exam, abnormal CT, and/or rising CA-125 levels. The median progression-free interval was 13 months (mean, 15.1 months; range, 2-33 months). Median overall survival was 27 months (mean, 34.2 months; range, 10-42 months). At the time of review, 13 (40.6%) of the 32 patients were alive with disease, 7 (21.9%) were without evidence of disease, and 12 (37.5%) were dead of disease. Conclusion. IP cisplatin in combination with IV paclitaxel appears to be no more effective than other reported regimens as second-line therapy for patients with persistent small-volume disease. Neurotoxicity is dose limiting, and the combination cannot be recommended for the routine care of persistent peritoneal cancers. (C) 2000 Academic Press.

Original languageEnglish (US)
Pages (from-to)28-32
Number of pages5
JournalGynecologic Oncology
Volume79
Issue number1
DOIs
StatePublished - 2000
Externally publishedYes

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Paclitaxel
Cisplatin
Therapeutics
TP protocol
Ovarian epithelial cancer
Platinum
Abdominal Pain
Disease Progression
Neoplasms
Catheters
Safety
Survival

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

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Intraperitoneal cisplatin and intravenous paclitaxel in the treatment of epithelial ovarian cancer patients with a positive second look. / Makhija, Sharmila K.; Sabbatini, P.; Aghajanian, C.; Venkatraman, E.; Spriggs, D. R.; Barakat, R.

In: Gynecologic Oncology, Vol. 79, No. 1, 2000, p. 28-32.

Research output: Contribution to journalArticle

Makhija, Sharmila K. ; Sabbatini, P. ; Aghajanian, C. ; Venkatraman, E. ; Spriggs, D. R. ; Barakat, R. / Intraperitoneal cisplatin and intravenous paclitaxel in the treatment of epithelial ovarian cancer patients with a positive second look. In: Gynecologic Oncology. 2000 ; Vol. 79, No. 1. pp. 28-32.
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abstract = "Objective. The aim of this study was to review the role and safety of intraperitoneal (IP) cisplatin and intravenous (IV) paclitaxel in platinum-sensitive epithelial ovarian cancer patients who were found to have small-volume disease (<1 cm) at the time of their second-look procedure. Methods. In a retrospective review, 32 patients with small-volume disease had an IP Bardport catheter placed at the time of second look at Memorial Sloan-Kettering Cancer Center (1995-1998). Patients received IP cisplatin (75 mg/m2) every 3 weeks and either IV paclitaxel (135 mg/m2) every 3 weeks or IV paclitaxel (80 mg/m2) weekly for a maximum of five cycles. Results. Twenty-four (75{\%}) of 32 patients received IP cisplatin/IV paclitaxel every 3 weeks and 8 (25{\%}) received IP cisplatin every 3 weeks with weekly IV paclitaxel. Seven (21.9{\%}) of 32 patients required interruption of treatment secondary to neuropathy. Of these, 4 (15.6{\%}) were changed to another IV chemotherapeutic agent, and 3 (9.3{\%}) required discontinuation of IV paclitaxel only. Two (6{\%}) patients required IP port removal secondary to malfunction and were changed to IV therapy and 1 (3{\%}) requested discontinuation of IP therapy secondary to abdominal pain. Median follow-up was 19 months (mean, 20.1 months; range, 6-36 months). Progression of disease after completion of IP therapy was documented by clinical exam, abnormal CT, and/or rising CA-125 levels. The median progression-free interval was 13 months (mean, 15.1 months; range, 2-33 months). Median overall survival was 27 months (mean, 34.2 months; range, 10-42 months). At the time of review, 13 (40.6{\%}) of the 32 patients were alive with disease, 7 (21.9{\%}) were without evidence of disease, and 12 (37.5{\%}) were dead of disease. Conclusion. IP cisplatin in combination with IV paclitaxel appears to be no more effective than other reported regimens as second-line therapy for patients with persistent small-volume disease. Neurotoxicity is dose limiting, and the combination cannot be recommended for the routine care of persistent peritoneal cancers. (C) 2000 Academic Press.",
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T1 - Intraperitoneal cisplatin and intravenous paclitaxel in the treatment of epithelial ovarian cancer patients with a positive second look

AU - Makhija, Sharmila K.

AU - Sabbatini, P.

AU - Aghajanian, C.

AU - Venkatraman, E.

AU - Spriggs, D. R.

AU - Barakat, R.

PY - 2000

Y1 - 2000

N2 - Objective. The aim of this study was to review the role and safety of intraperitoneal (IP) cisplatin and intravenous (IV) paclitaxel in platinum-sensitive epithelial ovarian cancer patients who were found to have small-volume disease (<1 cm) at the time of their second-look procedure. Methods. In a retrospective review, 32 patients with small-volume disease had an IP Bardport catheter placed at the time of second look at Memorial Sloan-Kettering Cancer Center (1995-1998). Patients received IP cisplatin (75 mg/m2) every 3 weeks and either IV paclitaxel (135 mg/m2) every 3 weeks or IV paclitaxel (80 mg/m2) weekly for a maximum of five cycles. Results. Twenty-four (75%) of 32 patients received IP cisplatin/IV paclitaxel every 3 weeks and 8 (25%) received IP cisplatin every 3 weeks with weekly IV paclitaxel. Seven (21.9%) of 32 patients required interruption of treatment secondary to neuropathy. Of these, 4 (15.6%) were changed to another IV chemotherapeutic agent, and 3 (9.3%) required discontinuation of IV paclitaxel only. Two (6%) patients required IP port removal secondary to malfunction and were changed to IV therapy and 1 (3%) requested discontinuation of IP therapy secondary to abdominal pain. Median follow-up was 19 months (mean, 20.1 months; range, 6-36 months). Progression of disease after completion of IP therapy was documented by clinical exam, abnormal CT, and/or rising CA-125 levels. The median progression-free interval was 13 months (mean, 15.1 months; range, 2-33 months). Median overall survival was 27 months (mean, 34.2 months; range, 10-42 months). At the time of review, 13 (40.6%) of the 32 patients were alive with disease, 7 (21.9%) were without evidence of disease, and 12 (37.5%) were dead of disease. Conclusion. IP cisplatin in combination with IV paclitaxel appears to be no more effective than other reported regimens as second-line therapy for patients with persistent small-volume disease. Neurotoxicity is dose limiting, and the combination cannot be recommended for the routine care of persistent peritoneal cancers. (C) 2000 Academic Press.

AB - Objective. The aim of this study was to review the role and safety of intraperitoneal (IP) cisplatin and intravenous (IV) paclitaxel in platinum-sensitive epithelial ovarian cancer patients who were found to have small-volume disease (<1 cm) at the time of their second-look procedure. Methods. In a retrospective review, 32 patients with small-volume disease had an IP Bardport catheter placed at the time of second look at Memorial Sloan-Kettering Cancer Center (1995-1998). Patients received IP cisplatin (75 mg/m2) every 3 weeks and either IV paclitaxel (135 mg/m2) every 3 weeks or IV paclitaxel (80 mg/m2) weekly for a maximum of five cycles. Results. Twenty-four (75%) of 32 patients received IP cisplatin/IV paclitaxel every 3 weeks and 8 (25%) received IP cisplatin every 3 weeks with weekly IV paclitaxel. Seven (21.9%) of 32 patients required interruption of treatment secondary to neuropathy. Of these, 4 (15.6%) were changed to another IV chemotherapeutic agent, and 3 (9.3%) required discontinuation of IV paclitaxel only. Two (6%) patients required IP port removal secondary to malfunction and were changed to IV therapy and 1 (3%) requested discontinuation of IP therapy secondary to abdominal pain. Median follow-up was 19 months (mean, 20.1 months; range, 6-36 months). Progression of disease after completion of IP therapy was documented by clinical exam, abnormal CT, and/or rising CA-125 levels. The median progression-free interval was 13 months (mean, 15.1 months; range, 2-33 months). Median overall survival was 27 months (mean, 34.2 months; range, 10-42 months). At the time of review, 13 (40.6%) of the 32 patients were alive with disease, 7 (21.9%) were without evidence of disease, and 12 (37.5%) were dead of disease. Conclusion. IP cisplatin in combination with IV paclitaxel appears to be no more effective than other reported regimens as second-line therapy for patients with persistent small-volume disease. Neurotoxicity is dose limiting, and the combination cannot be recommended for the routine care of persistent peritoneal cancers. (C) 2000 Academic Press.

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