CARBOPLATIN REINDUCTION AFTER TAXANE IN PATIENTS WITH PLATINUM-REFRACTORY EPITHELIAL OVARIAN-CANCER

Purpose: To determine the activity of carboplatin in patients with ova rian cancer who progressed on taxane (paclitaxel or docetaxel) therapy . Patients and Methods: Thirty-three patients with ovarian cancers ref ractory to platinum and taxane therapy were treated with single-agent carboplatin reinduction once the disease progressed on a taxane, The s tarting dose of carboplatin was 300 mg/m(2) at 28-day intervals. Resul ts: patients were a median age of 56 years (range, 31 to 80), had a me dian Zubrod performance status of 1 (range, 0 to 2) and had received a median of three prior chemotherapy regimens (range, two to eight) and one pretaxane platinum regimen (range, one to three), Twenty-six pati ents had a platinum-free interval of at least 12 months at the time of posttaxane re-treatment with carboplatin, There were seven of 33 (21% ) partial responses, with a median duration of 7+ months (range, 2+ to 12+), Responses were noted only in patients with at least a 12-month platinum-free interval and an initial sensitivity to a taxane, The the rapy was well tolerated and neurotoxicity was absent. Conclusion: A su bset of patients with platinum-refractory disease that initially respo nded to a taxane and who eventually have a platinum-free interval of a t least 1 year may respond to carboplatin reinduction. This finding ma y be secondary to paclitaxel or docetaxel therapy that leeds to the re versal of platinum resistance, or the prolonged platinum-free interval permits the loss of resistance to platinum by the tumor, Carboplatin reinduction should be considered in the treatment of patients whose ov arian cancer progresses after an initial sensitivity to a taxane and w ho had a prolonged platinum-free interval.