Combined pegylated liposomal doxorubicin and carboplatin in the treatment of recurrent epithelial ovarian cancer

Abstract

To evaluate the efficacy and toxicity of combined pegylated liposomal doxorubicin (PLD) and carboplatin in the treatment of patients with recurrent epithelial ovarian cancer. We retrospectively reviewed 67 patients with recurrent epithelial ovarian cancer or primary peritoneal adenocarcinoma (8 cases) who were treated with combined PLD and carboplatin. The response rate, survival and toxicity were evaluated. The mean age for 67 patients was 52.1 (39 - 76) years. All of them received cytoreductive surgery followed by platinum-based chemotherapy either with paclitaxel or cyclophosphamide and doxorubicin after diagnosis. Combined PLD and carboplatin was used as first or second-line treatment or even after multiple lines of treatment after disease recurred. Patients were treated with PLD at 35 - 40 mg/m(2) combined with carboplatin at an area under curve (AUC) of 5 once every 4 weeks. Forty-nine patients were evaluable for response. Twenty-three (47%) patients had a complete response, 13 (27%) had a partial response, 3 (6%) had stable disease and 10 (20%) had progressive disease. The estimated median progression-free survival (PFS) was 8 months. The 1-year and 2-year survival rates were 73% and 55%, respectively. All of the 67 patients were evaluated for toxicity. The treatment was terminated in 2 patients due to allergic-like infusion reaction. Four patients who had acute infusion reaction with shortness of breath and tightness of chest did not terminate the treatment because no such reaction occurred when restarted the infusion. There were 2 patients with G(2) and 3 patients with G(3) hand-foot syndrome, 2 patients had G(4) stomatitis, and 8 patients had G(3) leukopenia. No G(4) leukopenia or cardiotoxicity occurred. The combination of PLD and carboplatin is an active and well-tolerated regimen in the treatment of patients with recurrent epithelial ovarian cancer.