Wtb. Huinink et al., TOPOTECAN VERSUS PACLITAXEL FOR THE TREATMENT OF RECURRENT EPITHELIALOVARIAN-CANCER, Journal of clinical oncology, 15(6), 1997, pp. 2183-2193
Purpose: Topotecan and paclitaxel were evaluated in a randomized, mult
icenter study of patients with advanced epithelial ovarian carcinoma w
ho had progressed during or after one platinum-based regimen. Patients
and Methods: Patients received either topotecan (1.5 mg/m(2)) as a 30
-minute infusion daily for 5 days every 21 days (n = 112) or paclitaxe
l (175 mg/m(2)) infused over 3 hours every 21 days (n = 114). Patients
had bidimensionally measurable disease and were assessed for efficacy
and toxicity. Results: Response rate was 23 of 112 (20.5%) in topotec
an-treated patients and 15 of 114 (13.2%) in paclitaxel-treated patien
ts (P = .138). Disease stabilization for at least 8 weeks was noted in
30% of patients with topotecan and 33% of patients with paclitaxel. M
edian durations of response to topotecan and paclitaxel were 32 and 20
weeks, respectively (P = .222) and median times to progression were 2
3 and 14 weeks, respectively (P = .002). Median survival was 61 weeks
for topotecan and 43 weeks for paclitaxel (P = .515). Response rates f
or topotecan and paclitaxel were 13.3% versus 6.7% (P = .303) in resis
tant patients (not responded to prior platinum-based therapy or progre
ssed within 6 months of an initial response) and 28.8% versus 20.0% (P
= .213) in sensitive patients (progressed > 6 months after response).
Neutropenia wets significantly more frequent on the topotecan arm 79%
versus paclitaxel arm 23% (P < .01). It was short-lasting and noncumu
lative in both arms. Nonhematologic toxicities were generally mild (gr
ades 1 to 2) for both agents. Conclusion: Topotecan has efficacy at le
ast equivalent to paclitaxel manifested by the higher response rate an
d significantly longer time to progression. (C) 1997 by American Socie
ty of Clinical Oncology.