Topotecan versus paclitaxel for the treatment of recurrent epithelial ovarian cancer

Wim ten Bokkel Huinink, Martin Gore, James Carmichael, Alan Gordon, John Malfetano, Ian Hudson, Colin Broom, Claudio Scarabelli, Neville Davidson, Marek Spanczynski, Giorgio Bolis, Henric Malmström, Robert Coleman, Scott C. Fields, Jean Francois Heron

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Purpose: Topotecan and paclitaxel were evaluated in a randomized, multicenter study of patients with advanced epithelial ovarian carcinoma who had progressed during or after one platinum-based regimen. Patients and Methods: Patients received either topotecan (1.5 mg/m2) as a 30-minute infusion daily for 5 days every 21 days (n = 112) or paclitaxel (175 mg/m2) infused over 3 hours every 21 days (n = 114). Patients had bidimensionally measurable disease and were assessed for efficacy and toxicity. Results: Response rate was 23 of 112 (20.5%) in topotecan-treated patients and 15 of 114 (13.2%) in paclitaxel-treated patients (P = .138). Disease stabilization for at least 8 weeks was noted in 30% of patients with topotecan and 33% of patients with paclitaxel. Median durations of response to topotecan and paclitaxel were 32 and 20 weeks, respectively (P = .222) and median times to progression were 23 and 14 weeks, respectively(P = .002). Median survival was 61 weeks for topotecan and 43 weeks for paclitaxel (P = .515). Response rates for topotecan and paclitaxel were 13.3% versus 6.7% (P = .303) in resistant patients (not responded to prior platinum-based therapy or progressed within 6 months of an initial response) and 28.8% versus 20.0% (P = .213) in sensitive patients (progressed > 6 months after response). Neutropenia was significantly more frequent on the topotecan arm 79% versus paclitaxel arm 23% (P <.01). It was short-lasting and noncumulative in both arms. Nonhematologic toxicities were generally mild (grades 1 to 2) for both agents. Conclusion: Topotecan has efficacy at least equivalent to paclitaxel manifested by the higher response rate and significantly longer time to progression.

Original languageEnglish
Pages (from-to)2183-2193
Number of pages11
JournalJournal of Clinical Oncology
Issue number6
Publication statusPublished - Jun 1997

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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