522 Treatment of advanced ovarian cancer (AOC). From platinum compound to taxol: An indian experience

Abstract

From Jan. '91 patients with AOC have been treated with P (400 mg/m2 Q 4 W × 6) and cyclophosphamide (C) (600 mg/m2 Q 4 W × 6). Between Jan. '91–oct. '94 19 patients with AOC (St. III c = 15, St IV = 4) median age 53 yrs (36–73) were treated with PC Protocol. 15/19 had primary debulking, of which 5 were suboptimal. 4/19 received PC primum only 1/4 subsequently had suboptimal interval debulking, 3 progressed on therapy. Median Progression free interval for the group is 8 mths (1–47 range). There was no neurotoxicity, nephrotoxicity, Myelosuppression was minimal (gr I–II). PC although standard and well tolerated treatment survival remains suboptimal. Taxol (T) has been identified as an active agent in salvage therapy in AOC. T is being indigenously manufactured in India (Inlaxel, Dabur India ltd.) and available for use since Nov. '94. We have treated so far 2 patients of AOC primarily with P (300 mg/m2 Q4 W × 6) and T (135 mg/m2 escalated to 175 mg/m2 Q 4 W × 6). T is given as 3 hrs infusion followed by 1 hr infusion of P with premedication. The toxicity of TP is acceptable in the above doses. No cardiotoxicity, nausea gr I–II, myelosuppression gr I–II, arthralgia and myalgia managable with mild analgesic and mild autonomic disturbances were observed. We intend to escalate further the dose of T till such point where myelosuppression is manageable without support of growth factors, the target being higher dose intensity for better survival advantage. The data will be updated till Sep. '95 & discussed.