Efficacy of a modified regimen of gemcitabine and cisplatin among women with recurrent epithelial ovarian cancer

Abstract

Objective: To assess the efficacy, side effects and progression-free interval of a modified regimen of the combination ofgemcitabine and cisplatin among women with recurrent epithelial ovarian cancer. Methods: Twenty-eight women with recurrent epithelial ovarian, primary peritoneal or fallopian tube cancers were treated withgemcitabine (500 mg/m 2 ) followed by cisplatin (50 mg/m 2 ) on days one and eight every three weeks. Patients’ demographics,response, side effects, and progression-free interval were recorded. Result: The median age of patients was 61 (range 44-74 years). Twenty-three (82.1%) patients had platinum-sensitive and five(17.9%) had platinum-resistant tumors. The median number of prior chemotherapy regimens was two (range 1-4) and ninepatients had > three prior regimens. The median number of cycles was six (range 2-10). Seventeen (60.7%) patients respondedto chemotherapy (11 complete and six partial), six had stable disease and five had progression. The response rate was 69.6%and 20% among women with platinum-sensitive and platinum-resistant tumors, respectively ( P = .024). The median (range)progression-free interval was six (2-12) and nine (4-12) months among all patients and patients who responded to chemotherapy,respectively. Four patients had dose reductions, four had delays and three had their chemotherapy terminated secondary to toxicityor patient desire. There were no chemotherapy-related mortality or hospital admissions. The incidence of grade 3-4 neutropenia,anemia, thrombocytopenia, and nausea or vomiting was 32.1%, 10.7%, 35.7%, and 10.7%, respectively. Conclusion: The combination gemcitabine and cisplatin is highly effective among women with recurrent ovarian cancerincluding those who are heavily pre-treated and is reasonably tolerated. Although, the combination is effective among womenwith plantinum-resistant tumors, these women have a lower response than women with platinum-sensitive tumors.