Effectiveness of 2nd line chemotherapy in the treatment of ovarian cancer using gemcitabine- or ifosfamideand etoposide-based protocols – experience of the Department of Chemotherapy of the Centre of Oncology at Cracow, Poland
Krzysztof Krzemieniecki, Marek Ziobro, Tomasz Zemełka
Klinika Chemioterapii, Centrum Onkologii, Oddział w Krakowie. Kierownik Kliniki: dr med. J. Rolski
Adres do korespondencji: Klinika Chemioterapii, Centrum Onkologii – Instytut im. M. Skłodowskiej-Curie, Oddział w Krakowie, ul. Garncarska 11, 31-115 Kraków,
tel.: 012 423 10 34, faks: 012 423 15 89, e-mail: email@example.com
Source of financing: Department own sources
Introduction: Continuous increase of the incidence of ovarian cancer and poor treatment outcomes has prompted many clinical trials dealing with this problem. Chemotherapy based on the so-called golden standard (paclitaxel combined with platinum derivatives) did not result in any breakthrough in long-term survival rates and treatment outcomes. The use of topotecan or liposomal doxorubicin as 2nd line therapy of ovarian cancer has significantly increased treatment costs paralleled by relatively poor response rates. Aim of the study: Evaluation of effectiveness and toxicity of gemcitabine and of a combination of ifosfamide+etoposide in patients with ovarian cancer as 2nd line chemotherapy, implemented as an alternative systemic treatment modality after failure of platinum-based chemotherapy. Material and method: 97 patients were enrolled in this study; 72 thereof received a combination of ifosfamide and etoposide and the remaining 25 – gemcitabine. Results: Both protocols proved similarly active and resulted in clinical response in about 1/3 of patients. Response duration and time to progression were similar in both groups of patients. The use of gemcitabine was more demanding and bothersome, both in terms of administration schedule and toxicity profile. Conclusion: Ifosfamide- and etoposide+gemcitabine-based protocols may be an alternative to more expensive protocols of systemic treatment, resulting in a similar antineoplastic activity. Gemcitabine may be particularly useful in the elderly, in poor-grade patients and in those, who can be treated in the out-patient setting only.