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High-dose epirubicin in platinum-pretreated patients with ovarian carcinoma: the EORTC-GCCG experience
J B Vermorken1, A Kobierska, M E van der Burg
1Department of Oncology, Free University Hospital Amsterdam, The Netherlands.
Background:
A dose-response relationship for doxorubicin in ovarian cancer (OC) cell lines has been demonstrated in vitro. However, this has never been carefully addressed in the clinic. These data and the more favourable toxicity profile of the anthracycline analogue epirubicin were reasons to study high-dose epirubicin (HDE) in OC patients who relapsed on/after platinum-based chemotherapy. This was done both in a phase I/II feasibility study (n = 27; HDE dose 120-200 mg/m2 q3 weeks) and a still ongoing straightforward phase II study (n = 91; HDE dose 150-180 mg/m2 q 3 weeks).
Results:
Responses were observed at all dose levels. Overall 24 of the 118 patients responded (20%), which is much higher than reported with lower doses (7% with doses of 60-110 mg/m2). The most important side effects were myelosuppression, alopecia, nausea and vomiting and mucositis.
Conclusion:
HDE is tolerable and has activity in second-line after platinum-based chemotherapy in OC patients.