RESPONSE TO SALVAGE TREATMENT IN RECURRENT OVARIAN-CANCER TREATED INITIALLY WITH PACLITAXEL AND PLATINUM-BASED COMBINATION REGIMENS

Objective. The aim of this study was to evaluate the response to salva ge treatment in recurrent ovarian cancer treated initially with paclit axel-based chemotherapy. Methods. A retrospective review of patients w ith recurrent ovarian cancer treated with surgical debulking and pacli taxel-based chemotherapy was performed. All cases received second-line treatment with a response evaluated by clinical or surgical means. Da ta analysis was conducted using the SAS statistical package. Results. Fifty cases of advanced stage disease were available for review. Patie nts received paclitaxel and cisplatin or carboplatin with a 72.0% resp onse rate. The median time to recurrence after primary treatment was 6 months. Second-line treatment included cisplatin or carboplatin (50%) , Taxol (10%), or lutetium (22%), an intraperitoneal radiolabeled mono clonal antibody targeted to TAG-72. A 52.0% clinical response to salva ge treatment was detected. With a median follow-up of 7 months, 68.0% of patients had experienced recurrence or progression of their disease . The median time to second recurrence was 5 months. Cases sensitive t o initial paclitaxel-containing chemotherapy responded to any of the s alvage treatments more frequently than chemotherapy-resistant tumors ( 88.5% versus 11.5%, P < 0.05). Conclusions. Recurrent ovarian cancer p atients initially treated with paclitaxel-based chemotherapy frequentl y responded to salvage treatment. However, the duration of response wa s brief, and hospitalization for treatment-related side-effects was co mmon. Tumor response to initial paclitaxel/platinum treatment was pred ictive of future response to second-line agents. Current salvage thera pies appear to provide little benefit in cases of tumors resistant to primary chemotherapy. (C) 1998 Academic Press.