Clinical experience with combination paclitaxel and carboplatin therapy for advanced or recurrent carcinosarcoma of the uterus
ABSTRACT The purpose of the study was to evaluate the efficacy of combination chemotherapy with paclitaxel and carboplatin in patients with advanced or recurrent carcinosarcoma of the uterus.
A retrospective review was carried out at Miyagi Prefecture Cancer Research Center Hospital. Six patients pathologically diagnosed with uterine carcinosarcoma were treated with paclitaxel (175 mg/m(2) given intravenously over 3 h) and carboplatin (dosed at AUC 6) every 3 weeks at our center between 1997 and 2003. Responses and adverse effects were assessed according to Response Evaluation Criteria in Solid Tumors and National Cancer Institute-Common Toxic Criteria, respectively.
All six patients were evaluable for toxicity, and no unacceptably severe toxicities were reported. Grades 3 and 4 hematologic toxicities occurred, but all of them were overcome by adequate treatment with granulocyte colony-stimulating factor and blood transfusions. Five of six patients had measurable disease and thus were evaluable for response: Four patients had a complete response (CR) and the remaining patient had progressive disease (PD). The median progression-free interval (PFI) for all six cases was 18 months, with a median overall survival of 25 months.
Although the number of cases was small, the regimen evaluated in the current study demonstrated higher activity and lesser toxicity than those found in previous studies in patients with advanced or recurrent uterine carcinosarcoma. Additional phase II clinical studies are necessary to evaluate fully the benefits of this regimen.
- SourceAvailable from: Wenbin Wei[Show abstract] [Hide abstract]
ABSTRACT: Type II cancers account for 10% of endometrial cancers but 50% of recurrence. Response rates to chemotherapy at recurrence are poor and better prognostic markers are needed to guide therapy. CD151 is a small transmembrane protein that regulates cell migration and facilitates cancer metastasis. High CD151 expression confers poor prognosis in breast, pancreatic and colorectal cancer. The prognostic significance of tetraspanin CD151 expression in poor outcome endometrial cancers was evaluated, along with oestrogen receptor (ER), progesterone receptor (PR), p53, human epidermal growth factor receptor -2 (HER-2), and CD 151 staining compared with α6β1, α3β1 integrins, and E-cadherin. Tissue microarray constructed from 156 poor outcome endometrial cancers, tested with immunohistochemistry and staining correlated with clinicopathological data were used. A total of 131 data sets were complete for analysis. Expression of CD151 was significantly higher in uterine papillary serous and clear cell carcinoma than in grade 3 endometrioid carcinoma, sarcoma or carcinosarcoma (P<0.001). In univariate analysis, age, stage, histology type and CD151 were significant for both recurrence free (RFS) and disease specific survival (DSS). In multivariate analyses, CD151 was significant for RFS and DSS (P=0.036 and 0.033, respectively) in triple negative (ER, PR and HER-2 negative) tumours (88/131). The HER-2, p53, ER and PR were not prognostic for survival. There was strong concordance of CD151 with E-cadherin (98%), but not with α6β1 (35%), α3β1 staining (60%). The CD151 is a novel marker in type 2 cancers that can guide therapeutic decisions. CD151 may have an important role in tumourigenesis in some histology types.British Journal of Cancer 05/2011; 104(10):1611-8. DOI:10.1038/bjc.2011.80 · 4.82 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Malignancies are one of the major causes of morbidity and mortality in transplant patients. The incidence is progressively increasing either because of the increased age transplant patients and the increase of immunosuppressive therapy or the increased follow-up range post-transplantation. The main causes of increased tumor incidence in transplant patients with respect to the general population are the reduced immunosurveillance and the high incidence of infections due to oncogenic viruses. This problem might become more and more serious in the near future due to the introduction of new immunosuppressive strategies that significantly extend allograft survival. A case of ovarian cancer in a kidney transplant patient is described. Attention is focused on the potential dual role of immunosuppressive therapy in the development of malignancies in transplant patients.European journal of gynaecological oncology 02/2008; 29(1):89-92. · 0.60 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: A case of invasive leiomyosarcoma of the uterine corpus with right ovarian metastases in a 28-year-old woman is presented. The patient was submitted to surgery including total abdominal hysterectomy with left salpingo-oophorectomy, dissection of the pelvic and paraaortal lymph nodes and fixation of the right ovary to the psoas muscle. Postoperative radiation therapy was applied. A year after treatment, the patient was well.European journal of gynaecological oncology 02/2008; 29(1):98-100. · 0.60 Impact Factor