Experience in a UK Cancer Centre of Weekly Paclitaxel in the Treatment of Relapsed Ovarian and Primary Peritoneal Cancer

Abstract

Previous reports suggest that weekly paclitaxel (WP) treatment has significant activity in patients having ovarian or primary peritoneal cancer, and also that its toxicity profile is relatively favorable. This retrospective study audited the use of WP in 47 patients with recurrent ovarian cancer and 6 with primary peritoneal cancer who were cared for at a tertiary cancer center. All patients had previously received a platinum cytotoxic agent and 24 had received a taxane as well; the median number of treatments was 3. WP was given in a dose of 80-100 mg/m 2 ; the median number of weekly doses was 13. Toxicity was estimated using Common Toxicity Criteria, and the response by radiological findings and levels of cancer antigen-125 (CA-125). The overall response rate was 48% using radiological criteria and 69% based on CA-125 levels. Of 46 patients with measurable disease, 20 had a partial, and 2, a complete response. Five patients (11%) had progressive disease during WP treatment. The median progression-free survival time was 4.8 months, and the median overall survival time, 13.5 months. The use of taxanes did not influence the efficacy of WP therapy, nor were platinum-free or treatment-free intervals less than or greater than 6 months a factor. The most common grade 1-2 toxic effects were anemia, noted in 81% of patients, neutropenia in 57%, and peripheral neuropathy in 47%. Grade 3 toxicity included fatigue, peripheral neuropathy, and neutropenia-none affecting more than 15% of patients. No patient had grade 4 toxicity. The investigators conclude that WP therapy is a highly active and relatively well tolerated approach to relapsed ovarian cancer. Its use for treating recurrent disease is likely to increase.