Topotecan in the treatment of ovarian cancer

Abstract

Epithelial ovarian cancer is the eighth most common cancer and fifth most common cause of cancer-related death in women in the USA. While most women with Stage III/IV disease respond to first-line therapy with a platinum/taxane combination, only 10–30% are long-term survivors. Topotecan, a topoisomerase I inhibitor, is approved by the US FDA for the treatment of relapsed disease at a dose and schedule of 1.5 mg/m2/day for 5 days every 21 days. This schedule causes significant, noncumulative myelosuppression, and various alternate regimens have been explored. A randomized Phase II Gynecological Oncology Group trial is currently investigating weekly topotecan versus a five-times daily schedule. Multiple randomized trials have evaluated incorporation of topotecan in front-line treatment of ovarian cancer, although none have demonstrated benefit for this approach.