Objective. A phase II study of Mifepristone (RU486) was conducted in patien
ts with ovarian cancer whose tumors were resistant to cisplatin and paclita
xel, alone or in combination.
Patients and Methods. Forty-four patients were accrued into this study. All
had ovarian cancer that had become resistant to cisplatin and paclitaxel.
Patients received Mifepristone 200 mg orally on a daily basis. Patients wer
e followed by tumor size or CA-125 levels when there was no measurable dise
ase. A dose reduction of Mifepristone was to occur in the event of grade 3/
4 hematologic, GI, or liver toxicity, creatinine >2.5%, and grade 4 periphe
ral neuropathy.
Results. Thirty-four patients were evaluable for response, Nine (26.5%) of
these patients had a response to Mifepristone. Three(9%) patients had a com
plete response, and six (17.5%), a partial response, The response of one pa
tient in each group was measured by CA-125 levels while the remainder had m
easurable disease. The response lasted 1 to 4 months in all but one patient
. One patient continues to respond after more than 3 years. The major toxic
effect was a rash and this was the major reason patients were removed from
the study.
Conclusion. Mifepristone has activity against ovarian cancer resistant to c
isplatin and paclitaxel, The drug is well tolerated. Further studies need t
o be performed when this drug becomes more widely available in the United S
tates. (C) 2000 Academic Press.