Second line chemotherapy (CT) with gemcitabine (G) and vepesid (VP16) in platinum resistant (DDP-R) advanced ovarian cancer (AOC) patients

Abstract

5082 Background: Recurrent AOC patients (pts) often receive several CT lines, some of which have detrimental impact on life quality and high cost. VP16 and G are well tolerated, active, relatively unexpensive drugs; VP16 can be given orally. We evaluated the activity and the toxicity of this combination in platinum resistant pts. Methods: 27 AOC pts received i.v.G 1000 mg/sqm d.1 and 8 and VP16 p.o. 100 mg/day for 5 days (d.8 – 12) every 21 days. All pts were pretreated with platinum/taxol (PT) regimens (5 pts did not receive Taxol due to allergic reaction) and were primary (disease progression (PD) during PT) (16 pts) or secondary (DDP sensible pts re-treated with more than 2 CT lines) (11 pts) DDP-R; 13 pts received G-VP16 as second line whereas this was a third or more advanced line treatment for 14 pts. Topotecan and/or Pegylated Doxorubicin were used before this treatment. Median age was 65 yrs (range 30 – 82) and median ECOG PS was 0 (range 0 – 1). Results: In 2 pts CT was stopped after 1 course due to intolerance to G (skin reaction) and in 5 pts is still ongoing. In 20 evaluable pts, 4 complete (20%) and 9 (45%) partial responses were observed (objective response rate = 65%); 5 pts had disease stabilization (25%) while 2 pts exhibited PD (10%).Median response duration was 6 months (range 1–14). Only WHO grade 3 leucopenia in 1 pt and thrombocytopenia in 2 pts were observed; no supportive G-CSF therapy or hospitalisation was required. Conclusions: G-VP16 seems to be a promising, well tolerated and low expensive second line CT for DDP-R AOC pts. No significant financial relationships to disclose.