Improved outcomes with dose-dense paclitaxel-based neoadjuvant chemotherapy in advanced epithelial ovarian carcinoma

Academic Article

Abstract

  • © 2016 Elsevier Inc. Objective We compared tolerability, toxicity, response, and interval debulking surgery (IDS) outcomes between patients who received weekly dose-dense paclitaxel (DDP) and every three-week platinum to standard every three-week taxane plus platinum neoadjuvant chemotherapy (NACT) for advanced epithelial ovarian cancer (EOC). Methods We conducted a retrospective study of patients receiving NACT at our center between June 1, 2012 and July 31, 2015. Patients with stage III/IV EOC who received at least one cycle of DDP (weekly paclitaxel plus every three-week carboplatin) or standard taxane (every three-week paclitaxel or docetaxel plus carboplatin) therapy were included. Abstracted data included demographics, tolerability, grade 3/4 toxicity, response, and IDS outcomes. Fisher's exact and student t-test were used for statistical significance. Results Twenty-one patients received DDP and 40 received standard taxane. Tolerability was comparable. More patients receiving DDP experienced grade 3 or 4 toxicity when considered in aggregate (86% vs. 40%; p = 0.001). Pathologic complete response (pCR) was achieved in 14% of DDP patients versus 3% of standard (p = 0.11). 48% of patients in the DDP group were debulked to no residual disease (NRD) versus 28% in the standard group (p = 0.16). Conclusions While associated with an increase in severe toxicity compared to standard three-week taxane, DDP appears to facilitate higher rates of pCR and NRD for patients receiving NACT in this preliminary study. These results warrant further investigation of DDP for patients with advanced EOC and assessment of impact on long-term survival outcomes.
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    Author List

  • Becker DA; Thomas ED; Gilbert AL; Boone JD; Straughn JM; Huh WK; Bevis KS; Leath CA; Alvarez RD
  • Start Page

  • 25
  • End Page

  • 29
  • Volume

  • 142
  • Issue

  • 1