Article

Cisplatin as initial chemotherapy in ovarian carcinosarcomas: a Gynecologic Oncology Group study.

Department of Medicine, University of Mississippi School of Medicine, Jackson, MS 39216-4505, USA.
Gynecologic Oncology (impact factor: 3.89). 05/2004; 93(2):336-9. DOI:10.1016/j.ygyno.2004.01.007 pp.336-9
Source: PubMed

ABSTRACT Carcinosarcomas of the ovary are rare; hence, although most patients recur after surgical resection or have metastatic disease at the time of diagnosis, only anecdotal information is available concerning the activity of cytotoxic drugs against these lesions. The Gynecologic Oncology Group (GOG) initiated a concerted effort to study cytotoxic therapy for these cancers in 1976. This report presents data on cisplatin, the first of the agents to be studied in this disease.
One hundred thirty-six eligible patients with ovarian carcinosarcoma received cisplatin (50 mg/m(2)) every 3 weeks until disease progression or unacceptable toxicity.
Among 44 patients evaluable for response, one complete (2%) and eight partial (18%) responses resulted. An additional 10 (23%) patients exhibited stable disease, while 25 (57%) had increasing disease. Median progression-free survival in 130 patients evaluable for this endpoint was 5.2 months. Median survival in the same 130 patients was 11.7 months. Adverse effects >/=grade 2 among the 132 patients evaluable for toxicity included leukopenia (14%), neutropenia (17%), thrombocytopenia (2%), anemia (10%), nausea and vomiting (40%), azotemia (3%), neurotoxicity (4%), fever (2%), and tinnitus (1%).
These data provide the first objective evidence that cisplatin is active as an initial therapy for patients who have carcinosarcoma of the ovary. The overall response rate (20%) is similar to that seen in carcinosarcomas of the uterus.

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Keywords

130 patients evaluable
 
132 patients evaluable
 
3 weeks
 
44 patients evaluable
 
additional 10
 
agents
 
anecdotal information
 
concerted effort
 
cytotoxic drugs
 
disease progression
 
first objective evidence
 
Gynecologic Oncology Group
 
hundred thirty-six eligible patients
 
initial therapy
 
Median progression-free survival
 
metastatic disease
 
ovarian carcinosarcoma
 
report presents data
 
study cytotoxic therapy
 
surgical resection
 

J Tate Thigpen