Continuous oral cyclophosphamide as salvage or maintenance therapy in ovarian, primary peritoneal, and fallopian tube cancers: A retrospective, single institute study

Abstract

ObjectiveMost patients with recurrent ovarian cancer are treated with multiple regimens of intravenous salvage chemotherapy. These anticancer agents often cause severe toxicities and offset their therapeutic effects. The present study assessed the experience of a single institute regarding the safety and treatment outcomes of continuous oral cyclophosphamide in patients with ovarian, primary peritoneal, and fallopian tube cancers. Materials and methodsA retrospective review was conducted on patients who received oral cyclophosphamide as salvage or maintenance therapy. All the patients had received platinum plus paclitaxel as the front line chemotherapy before being enrolled in the study. Oral cyclophosphamide 50 or 100 mg daily was administered. The response rate, progression-free survival, and side effects were evaluated. ResultsTwenty patients were eligible for analysis, and 18 patients (90%) initially had FIGO stage IIIC disease. Most patients were heavily pretreated with the median number of previous chemotherapy regimens being 4 (range 1–8). Seventeen patients received oral cyclophosphamide as salvage therapy. Complete and partial responses were obtained in 3 and 2 patients, respectively. Five patients were classified as having stable disease. The median progression-free survival was 15 weeks (range 5–60 weeks). Three patients received oral cyclophosphamide as maintenance therapy in the remission status. The remission duration was maintained for 18, 28, and 67 weeks. Grade 2–3 myelosuppression was the only side effect. ConclusionContinuous oral cyclophosphamide can be used as an alternative salvage therapy in recurrent ovarian cancer with an acceptable response rate and toxicity. Additional clinical trials are required to evaluate its efficacy as maintenance therapy.