卵巢上皮性癌(epithelial ovarian cancer,卵巢癌)不易早期诊断,75%的患者就诊时已处于晚期[国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)Ⅲ~Ⅳ期],肿瘤常累及壁层腹膜和(或)发生腹盆腔内广泛转移,其...卵巢上皮性癌(epithelial ovarian cancer,卵巢癌)不易早期诊断,75%的患者就诊时已处于晚期[国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)Ⅲ~Ⅳ期],肿瘤常累及壁层腹膜和(或)发生腹盆腔内广泛转移,其病死率居妇科恶性肿瘤的首位。展开更多
Objective The aim of the study was to evaluate the role of ATP-based tumor chemosensitivity assay(ATP-TCA) in patients with platinum-resistant recurrent ovarian cancer(PRROC).Methods A total of 43 patients with PRROC ...Objective The aim of the study was to evaluate the role of ATP-based tumor chemosensitivity assay(ATP-TCA) in patients with platinum-resistant recurrent ovarian cancer(PRROC).Methods A total of 43 patients with PRROC who underwent chemotherapy based on the results of ATPTCA in the Cancer Hospital,Chinese Academy of Medical Sciences were included in the present study.As controls,we selected another 43 patients with PRROC who were treated at the physician's discretion within the same time period and had the same clinical characteristics as the patients in the ATP-TCA group.Logrank test and Cox proportional hazards model were adopted for analysis.Results A total of 86 patients were retrospectively analyzed in the present study.Patients were routinely monitored to evaluate the rate of progression-free survival(PFS).The median follow-up time was 13 months.The PFS for the ATP-TCA and control groups was 5 and 3 months,respectively(P = 0.027).Multivariate analysis showed that the type of treatment was an independent prognostic factor for PFS(P = 0.040;HR:0.623;95% CI:0.313–0.973).Subgroup analysis showed that among patients with a treatmentfree interval(TFI) of ≥ 3 months(n = 50),those in the ATP-TCA group had longer PFS than those in the control group(7 vs 4 months,P = 0.010).Meanwhile,the median PFS of patients who underwent ≤ 2 prior chemotherapy regimens(PCR,n = 52) in the ATP-TCA and control groups was 6 months and 4 months,respectively(P = 0.025).Conclusion ATP-TCA-directed chemotherapy might improve the PFS in PRROC.In particular,the survival benefit from ATP-TCA is higher in patients with a TFI of ≥ 3 months or treated with ≤ 2 PCR.展开更多
AIM： To report the results of two phase Ⅱ studies of chemotherapy in patients with platinum-resistant and platinum-refractory ovarian cancer and discuss the cur-rent status of systemic therapy in this disease.METHOD...AIM： To report the results of two phase Ⅱ studies of chemotherapy in patients with platinum-resistant and platinum-refractory ovarian cancer and discuss the cur-rent status of systemic therapy in this disease.METHODS： Two subsequent Austrian Arbeitsgemein-schaft für Gynkologische Onkologie （AGO） phase Ⅱ studies have been carried out. Patients either had platinum-refractory or platinum-resistant disease, i.e., disease progression during first line platinum-based therapy or recurrence within 6 mo following the last platinum-containing chemotherapy, respectively. In the first study, 6 cycles of irinotecan at 55 mg/m2 and docetaxel 25 mg/m2 were both administered on days 1, 8 and 15 of a 4 wk cycle. In the second phase Ⅱ study, either non-pegylated （PEG） liposomal doxorubi-cin （L-DXR） 60 mg/m2 monotherapy on day 1 and PEG filgrastim on day 2 （arm A） or L-DXR at 50 mg/m2 and gemcitabine （GEM） at 650 mg/m2 on day 1 and GEM on day 8 （arm B） were administered every 4 wk. Patients in arm B received prophylactic filgrastim 5 μg/kg per day from days 3 to 6 and from days 9 to 12, respec-tively. RESULTS： Response rates in studies were 14% and 17%, respectively. The progression-free survival was less than 3 mo. Diarrhea was most prevalent in patients treated with irinotecan ＋ docetaxel, while stomatitis/mucositis occurred in a quarter of patients treated with L-DXR ＋/- GEM ＋ granulocyte colony stimulating factor, respectively. Following treatment with the latter regi-men, a total of 11 serious adverse events were record-ed among the 12 patients included. The rate of remis-sions of the regimens used in these two Austrian AGOstudies was low and their toxicity significant. Due to their low therapeutic index, neither of these regimens can be recommended in this heavily pretreated patient population with platinum-resistant ovarian cancer ex-hibiting a high tumor-associated symptom burden. CONCLUSION： The two reported phase Ⅱ studies of the Austrian AGO in platinum-resistant disease ha展开更多
文摘卵巢上皮性癌(epithelial ovarian cancer,卵巢癌)不易早期诊断,75%的患者就诊时已处于晚期[国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)Ⅲ~Ⅳ期],肿瘤常累及壁层腹膜和(或)发生腹盆腔内广泛转移,其病死率居妇科恶性肿瘤的首位。
基金Supported by a grant from the Capital’s Funds for Health Improvement and Research(No.Z131107002213013)
文摘Objective The aim of the study was to evaluate the role of ATP-based tumor chemosensitivity assay(ATP-TCA) in patients with platinum-resistant recurrent ovarian cancer(PRROC).Methods A total of 43 patients with PRROC who underwent chemotherapy based on the results of ATPTCA in the Cancer Hospital,Chinese Academy of Medical Sciences were included in the present study.As controls,we selected another 43 patients with PRROC who were treated at the physician's discretion within the same time period and had the same clinical characteristics as the patients in the ATP-TCA group.Logrank test and Cox proportional hazards model were adopted for analysis.Results A total of 86 patients were retrospectively analyzed in the present study.Patients were routinely monitored to evaluate the rate of progression-free survival(PFS).The median follow-up time was 13 months.The PFS for the ATP-TCA and control groups was 5 and 3 months,respectively(P = 0.027).Multivariate analysis showed that the type of treatment was an independent prognostic factor for PFS(P = 0.040;HR:0.623;95% CI:0.313–0.973).Subgroup analysis showed that among patients with a treatmentfree interval(TFI) of ≥ 3 months(n = 50),those in the ATP-TCA group had longer PFS than those in the control group(7 vs 4 months,P = 0.010).Meanwhile,the median PFS of patients who underwent ≤ 2 prior chemotherapy regimens(PCR,n = 52) in the ATP-TCA and control groups was 6 months and 4 months,respectively(P = 0.025).Conclusion ATP-TCA-directed chemotherapy might improve the PFS in PRROC.In particular,the survival benefit from ATP-TCA is higher in patients with a TFI of ≥ 3 months or treated with ≤ 2 PCR.
文摘AIM： To report the results of two phase Ⅱ studies of chemotherapy in patients with platinum-resistant and platinum-refractory ovarian cancer and discuss the cur-rent status of systemic therapy in this disease.METHODS： Two subsequent Austrian Arbeitsgemein-schaft für Gynkologische Onkologie （AGO） phase Ⅱ studies have been carried out. Patients either had platinum-refractory or platinum-resistant disease, i.e., disease progression during first line platinum-based therapy or recurrence within 6 mo following the last platinum-containing chemotherapy, respectively. In the first study, 6 cycles of irinotecan at 55 mg/m2 and docetaxel 25 mg/m2 were both administered on days 1, 8 and 15 of a 4 wk cycle. In the second phase Ⅱ study, either non-pegylated （PEG） liposomal doxorubi-cin （L-DXR） 60 mg/m2 monotherapy on day 1 and PEG filgrastim on day 2 （arm A） or L-DXR at 50 mg/m2 and gemcitabine （GEM） at 650 mg/m2 on day 1 and GEM on day 8 （arm B） were administered every 4 wk. Patients in arm B received prophylactic filgrastim 5 μg/kg per day from days 3 to 6 and from days 9 to 12, respec-tively. RESULTS： Response rates in studies were 14% and 17%, respectively. The progression-free survival was less than 3 mo. Diarrhea was most prevalent in patients treated with irinotecan ＋ docetaxel, while stomatitis/mucositis occurred in a quarter of patients treated with L-DXR ＋/- GEM ＋ granulocyte colony stimulating factor, respectively. Following treatment with the latter regi-men, a total of 11 serious adverse events were record-ed among the 12 patients included. The rate of remis-sions of the regimens used in these two Austrian AGOstudies was low and their toxicity significant. Due to their low therapeutic index, neither of these regimens can be recommended in this heavily pretreated patient population with platinum-resistant ovarian cancer ex-hibiting a high tumor-associated symptom burden. CONCLUSION： The two reported phase Ⅱ studies of the Austrian AGO in platinum-resistant disease ha
