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Sequential Couplets of Cisplatin/Topotecan and Cisplatin/Paclitaxel
as First-Line Therapy in Advanced Epithelial
University of Pennsylvania Cancer Center
Last Modified: May 16, 1999
Dr. P. Hoskins presented a Phase II trial of sequential couplets of cisplatin (DDP) and topotecan (TOP) and cisplatin and paclitaxel (T) as first-line therapy for advanced epithelial ovarian cancer on behalf of the National Cancer Institute of Canada. The dosage used were as follows:
DDP/TOP cycles: DDP 50 mg/m2 and TOP 0.75 mg/m2
DDP/T cycles: DDP 75 mg/m2 and T 135 mg/m2 IV infusion over 24 hours
Interval debulking was allowed.
Dr. Hoskins reported that:
- Dose reduction was needed in 13% of DDP/TOP cycles
- Dose delays were incurred in 9% of DDP/TOP cycles
- A response rate of 85%
Dr. Hoskins concluded that:
- Myelotoxcity of this couplet regimen is high but does not prevent delivery.
- The response rate is encouraging being that these were predominately suboptimal patients.
This presentation was discussed by David Spriggs, M.D. from Memorial Sloan-Kettering Cancer Center. Dr. Spriggs had reservations:
- Cisplatin was used instead of carboplatin
- Marked reduction in topotecan dosing
- Treatment delay was common
- Substantial toxicity