Abstract
From August 1995 to December 1997, 15 patients with stage III–IV ovarian cancer were treated with outpatient intensive chemotherapy with G-CSF and stem cell support. The first cycle consisted of cyclophophamide IV 6 g/m2; second, third, fourth and fifth paclitaxel 250 mg/m2 and the sixth and seventh carboplatin AUC 18. CD34+ cells were collected after the first cycle and reinfused after completion of cycles 6 and 7. Fourteen patients had stage IIIc and one patient had stage IV disease with liver metastases. All patients underwent laparotomy to maximize tumor debulking. This was optimal in eight patients and suboptimal in seven patients. Second-look surgery was performed in 14 patients. All patients had macroscopic complete responses and 10 patients had complete histologic response. Median follow-up was 48 months (range, 20 to 62). Twelve patients had further progression at a median of 27 months (range, 9 to 42) and nine are alive, three without evidence of disease progression. This pilot study shows that dose-dense chemotherapy with paclitaxel and carboplatin is associated with low toxicity and may improve the outcome of patients with poor prognosis ovarian cancer.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Cannistra S . Cancer of the ovary New Engl J Med 1993 329: 1550 1559
Gershenson DM, Copeland LJ, Wharton JT et al. Prognosis of surgically determined complete responders in advanced ovarian cancer Cancer 1985 55: 1129 1135
Omura GA, Bundy BN, Berek JS et al. Randomized trial of cyclophosphamide plus cisplatin with or without doxorubicin in ovarian carcinoma: a Gynecologic Oncology Group study J Clin Oncol 1989 7: 457 465
Neijt JP, ten Bokkel Huinink WW, van der Burg M et al. Randomized trial comparing two combination chemotherapy regimens (CHAP-5 vs CP) in advanced ovarian carcinoma J Clin Oncol 1987 5: 1157 1168
McGuire WP, Hoskins WJ, Brady MF et al. Cyclophosphamide and cisplatin compared with paclitaxel and cisplatin in patients with stage III and stage IV ovarian cancer New Eng J Med 1996 334: 1 16
Piccart MJ, Bertelsen K, James K et al. Randomized intergroup trial of cisplatin-paclitaxel versus cisplatin-cyclophosphamide in women with advanced epithelial ovarian cancer: three-year results J Nat Cancer Inst 2000 92: 699 708
Behrens BC, Hamilton TC, Masuda H et al. Characterization of a cis-diamminechloroplatinum(II)-resistant human ovarian cancer cell line and its use in evaluation of platinum analogues Cancer Res 1987 47: 414 418
Levin L, Hryniuk WM . Dose intensity analysis of chemotherapy regimens in ovarian carcinoma J Clin Oncol 1987 5: 756 767
Levin L, Simon R, Hryniuk W . Importance of multiagent chemotherapy regimens in ovarian carcinoma: dose intensity analysis J Natl Cancer Inst 1993 85: 1732 1742
Dauplat J, Legos M, Condat J et al. High-dose melphalan and autologous bone marrow support for treatment of ovarian carcinoma with positive second-look operation Gynecol Oncol 1989 34: 294 298
Bertucci F, Viens P, Delpero JR et al. High-dose melphalan-based chemotherapy and autologous stem cell transplantation after second look laparotomy in patients with chemosensitive advanced ovarian carcinoma: long-term results Bone Marrow Transplant 2000 26: 61 67
Viens P, Maraninchi D, Legros M et al. High dose melphalan and autologous marrow rescue in advanced epithelial ovarian carcinomas: a retrospective analysis of 35 patients treated in France Bone Marrow Transplant 1990 5: 227 233
Legros M, Dauplat J, Fleury J et al. High-dose chemotherapy with hematopoietic rescue in patients with stage III or IV ovarian cancer: long-term results J Clin Oncol 1997 15: 1302 1308
Stiff PJ, Bayer R, Kerger C et al. High-dose chemotherapy with autologous transplantation for persistent/relapsed ovarian cancer: a multivariate analysis of survival for 100 consecutively treated patients J Clin Oncol 1997 15: 1309 1317
Stoppa AM, Bouabdallah R, Chabannon C et al. Intensive sequential chemotherapy with repeated blood stem-cell support for untreated poor-prognosis non-Hodgkin's lymphoma J Clin Oncol 1997 15: 1722 1729
Schilder RJ, Johnson S, Gallo J et al. Phase I trial of multiple cycles of chemotherapy supported by autologous peripheral-blood stem cells J Clin Oncol 1999 17: 2198 2207
Aghajanian C, Fennely D, Shapiro F et al. Phase II study of ‘dose-dense’ high-dose chemotherapy treatment with peripheral-blood progenitor-cell support as primary treatment for patients with advanced ovarian cancer J Clin Oncol 1998 16: 1852 1860
Norton L . Kinetic concepts in the systemic drug therapy of breast cancer Semin Oncol 1999 26: 11 20
Budman D, Berry DA, Cirrincione CT et al. Dose and dose intensity as determinants of outcome in the adjuvant treatment of breast cancer. The Cancer and Leukemia Group B J Natl Cancer Inst 1998 19: 1205 1211
Chatelut E, Canal P, Brunner V et al. Prediction of carboplatin clearance from standard morphological and biological patient characteristics J Nat Cancer Institute 1995 87: 573 580
Chabannon C, Le Coroller AG, Faucher C et al. Patient condition affects the collection of peripheral blood progenitors after priming with recombinant granulocyte colony-stimulating factor J Hematother 1995 4: 171 179
Kaplan EL, Meier P . Non parametric estimation from incomplete observations J Am Stat Assoc 1971 53: 457 481
Pierelli L, Perillo A, Greggi S et al. Erythropoietin addition to granulocyte colony-stimulating factor abrogates life-threatening neutropenia and increases peripheral-blood progenitor-cell mobilization after epirubicin, paclitaxel, and cisplatin combination chemotherapy: results of a randomized comparison J Clin Oncol 1999 17: 1288 1295
Reiffers J, Cailliot C, Dazey B et al. Abrogation of post-myeloablative chemotherapy neutropenia by ex vivo expanded autologous CD34-positive cells Lancet 1999 354: 1092 1093
Berek J . Epiththelial ovarian cancer In: Berek JS, Hacker NF (eds) Practical Gynecologic Oncology William & Wilkins: Baltimore 1994 pp 327 382
Rubin S, Randall T, Armstrong K et al. Ten-year follow-up of ovarian cancer patients after second-look laparotomy with negative findings Obstet Gynecol 1999 93: 21 24
Wandt H, Birkmann J, Denzel T et al. Sequential cycles of high-dose chemotherapy with escalation of carboplatin with or without paclitaxel supported by G-CSF mobilized peripheral blood progenitor cells: a phase I/II study in advanced ovarian cancer Bone Marrow Transplant 1999 23: 763 770
Fennelly D, Schneider J, Spriggs D et al. Dose escaladation of paclitaxel with high-dose cyclophosphamide, with analysis of progenitor-cell mobilization and hematologic support of advanced ovarian cancer patients receiving rapidly sequenced high-dose carboplatin/cyclophosphamide courses J Clin Oncol 1995 13: 1160 1166
Cure H, Battista C, Guastalla J et al. Phase III randomized trial of high-dose chemotherapy and peripheral blood stem cell support as consolidation in patients with responsive low-burden advanced ovarian cancer: preliminary results of a GINECO/FNCLCC/ SFGM-TC study Proc Am Soc Clin Oncol 2001 20: 204a (Abstr. 815)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Viret, F., Bertucci, F., Genre, D. et al. Intensive sequential dose dense chemotherapy with stem cell support as first-line treatment in advanced ovarian carcinoma: a phase II study. Bone Marrow Transplant 30, 879–884 (2002). https://doi.org/10.1038/sj.bmt.1703762
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1703762
Keywords
This article is cited by
-
Are there candidates for high-dose chemotherapy in ovarian carcinoma?
Journal of Experimental & Clinical Cancer Research (2012)
-
Post-operative sequential high-dose chemotherapy with haematopoietic stem cell support as front-line treatment in advanced ovarian cancer: a phase II multicentre study
Bone Marrow Transplantation (2006)