Residual neurotoxicity in patients with ovarian cancer in clinical remission after first-line chemotherapy with carboplatin and paclitaxel: The Multicenter Italian Trials in Ovarian cancer (MITO-4) retrospective study

Abstract

5015 Background: carboplatin/paclitaxel (CP) is the chemotherapy (CT) of choice for advanced ovarian cancer. Although a significant proportion of patients (pts) have some neurotoxicity during treatment, the long-term outcome of CT-induced neuropathy has been scantly studied. We retrospectively assessed the prevalence of residual neuropathy in a cohort of pts in clinical remission after first-line CP for advanced ovarian cancer. Patients and Methods: 120 consecutive pts have been enclosed in this study. All pts received C (AUC 5) plus P (175 mg/m2) every 3 weeks for 6 cycles, completing treatment between 1998 and 2003. 49 pts (41%), assigned to the experimental arm of the MITO-1 study, had received 4 courses of topotecan (1.5 mg/m2 for 5 days every 3 weeks) after CP, as consolidation therapy. Data have been collected between May and September 2004. Residual sensory and motor neurotoxicity have been coded according to the NCI CTC v2.0. Results: 55 pts (46%) did not experience any grade of neurological toxicity during CT: none of them had signs of neuropathy during follow up. The other 65 pts (54%) had CT-induced neurotoxicity during treatment and follow-up data are available for 60 of them. 46/60 pts (77%) had no residual neuropathy at the moment of interview: in detail, recovery from neurotoxicity had occurred in the first 2 months after the end of CT in 22 (37%), between 2 and 6 months in 15 (25%), or after more than 6 months in 9 (15%). The remaining 14/60 pts (23%) referred residual neuropathy at the most recent follow-up visit, after a median follow up of 18 months (range, 7–58 months): 12 pts had G1 and 2 pts G2 peripheral sensory neuropathy; 3 pts had also G1 motor neuropathy. Overall, at 6 months, 23 out of 120 pts (19%) had some residual neurotoxicity. Conclusions: our data indicate that a significant proportion of patients with advanced ovarian cancer treated with first-line CT with carboplatin/paclitaxel suffer long-term residual neuropathy. This issue should be carefully taken into account before considering a re-treatment with the same agents in sensitive recurrent disease. No significant financial relationships to disclose.