AN INTERESTING REGIMEN FOR MIXED MULLERIAN TUMORS

Br J Cancer. 2011 Aug 16. doi: 10.1038/bjc.2011.316. [Epub ahead of print]

Paclitaxel-ifosfamide-carboplatin combination chemotherapy regimen in advanced uterine and adnexal malignant mixed Mullerian tumours.

Kosmas C, Vorgias G, Tsakonas G, Politis P, Daladimos T, Panagiotidi E, Papachrysanthou T, Moschovis D, Kalinoglou N, Tsavaris N, Karabelis A, Mylonakis N.

Source

Second Division of Medical Oncology, Department of Medicine, 'Metaxa' Cancer Hospital, Piraeus, Greece.

Abstract

Background:Malignant mixed Mullerian tumours (MMMTs) of the uterus and adnexa represent aggressive gynaecologic malignancies with a high rate of loco-regional and distant failure. For that reason, we evaluated the paclitaxel-ifosfamide-carboplatin (TICb) combination in patients with advanced MMMTs.Methods:Female patients with advanced MMMTs, WHO-PS 0-2, no prior chemotherapy for systemic disease, unimpaired haemopoietic and organ function were eligible. Chemotherapy was administered at the following doses; paclitaxel: 175 mg m(-2) on day 1, ifosfamide: 2.0g m(-2) day(-1) - days 1 and 2, and carboplatin at a target area under the curve 5 on day 2, with prophylactic G-CSF from day 3.Results:Forty patients of a median age 61 (45-72) years, performance status 0-2 with advanced MMMTs of the uterus (n=34), tubes (n=2) or ovary (n=4) have entered and all were evaluable for response and toxicity. Responses were as follows: 27 out of 40 (67.5%) evaluable patients responded, with 11 complete responses and 16 partial responses, while 10 had stable disease, and 3 developed progressive disease. The median response duration was 9 months (range, 4-40 months), median progression-free survival 13 months (range, 3-42 months), while median overall survival 18 months (range, 4-48 months). Grade 3/4 neutropenia was recorded in 22 out of 40 (55%) - with 13 developing grade 4 (7 days) and 7 out of 40 (17.5%) of patients at least one episode of febrile neutropenia.Conclusion:In this study, it appears that the TICb combination, yielded important activity with manageable toxicity in females with advanced MMMTs warranting further randomised comparison with current standard regimens.British Journal of Cancer advance online publication, 16 August 2011; doi:10.1038/bjc.2011.316 www.bjcancer.com.