Treatment of relapsed carcinoma of the ovary with single-agent paclitaxel following exposure to paclitaxel and platinum employed as initial therapy

Objectives. The aim of this study was to evaluate the ability of paclitaxel to achieve a second clinical response in patients with recurrent epithelia l ovarian carcinoma who responded to standard therapy with platinum and pac litaxel in the initial setting. Methods. Thirty-four patients with epithelial ovarian who demonstrated a co mplete response to paclitaxel and platinum in the initial treatment setting were retreated with paclitaxel as a single agent for relapse of their dise ase, Paclitaxel was given at a dose of 135-175 mg/m(2) over 3 h at 21-day i ntervals. Fifteen patients had platinum-resistant disease and 19 had potent ially platinum-sensitive disease. Response was documented by physical exami nation, serial serum CA125 measurement, or radiologic evaluation. Results, An objective response to paclitaxel retreatment was demonstrated i n 15 patients (44%), with a median progression-free interval (PFI) of 8.6 m onths (range 4-17 months). An additional 14 patients (41%) demonstrated dis ease stabilization, with a median PFI of 7.4 months (range 3-13 months). Ov erall, retreatment with paclitaxel was well tolerated, with minimal cumulat ive toxicities, despite repetitive dosing. Conclusion. These results demonstrate that patients with ovarian cancer who relapse after initial treatment with paclitaxel often have disease that is still responsive to the agent. Given its relative lack of cumulative toxic ity, retreatment with paclitaxel as a single agent is a reasonable therapeu tic option for patients with recurrent ovarian-cancer, (C) 2000 Academic Pr ess.