belotecan and Carcinoma

This study was performed to determine the safety and efficacy of belotecan, a new camptothecin analogue and potent topoisomerase I inhibitor, with and without platinum in patients with recurrent ovarian cancer.. Fifty-three patients with recurrent or persistent ovarian cancer were enrolled between March 2005 and March 2008. Eligible patients received 0.5 mg/m of intravenous (IV) belotecan on days 1 to 5, every 3 weeks belotecan monotherapy (B) or 50 mg/m of IV cisplatin on day 1 plus 0.3 mg/m of IV belotecan on days 1 to 5, every 3 weeks (belotecan plus cisplatin combination therapy [BP]).. Of the 53 treated patients, 34 received BP and 19 received B. Thirty-four patients had platinum-sensitive (PS) disease and 19 had platinum-resistant disease. The overall response of the 53 patients was 37.7% (20/53). According to regimen, the response rate in the BP group was 47.1% (16/34) and that of the B group was 21.1% (4/19). BP had better response (66.7%, 14/21) than B (15.4%, 2/13) for PS disease (P = 0.004), but it was not superior in terms of progression-free survival (BP, 6 month; B, 7 months). Grade 3 or 4 toxicity was less common in B than in BP.. Both BP and B seems to be effective and safe regimens for patients with PS or platinum-resistant recurrent ovarian cancer. These results warrant further prospective randomized trials. Both BP and B seems to be effective and safe regimens for patients with PS or platinum-resistant recurrent ovarian cancer.

Topics: Adult; Aged; Antineoplastic Agents, Phytogenic; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Carcinoma; Cisplatin; Disease-Free Survival; Drug Resistance, Neoplasm; Female; Hematologic Diseases; Humans; Middle Aged; Neoplasm Recurrence, Local; Organoplatinum Compounds; Ovarian Neoplasms; Salvage Therapy; Survival Analysis; Treatment Outcome

The efficacy of second-line chemotherapy for relapsed primary peritoneal serous carcinoma has been numerously reported, but reports on durable response after second-line therapy have been rare. We report the case of a 66-year-old woman with relapsed primary peritoneal serous carcinoma who showed durable response after just one cycle of second-line belotecan-based therapy. The response might be a complete pathologic remission. Considering the fact that our patient suffered from neutropenic sepsis during her treatment, we concluded that belotecan-based chemotherapy could be a good option for second-line chemotherapy in some selected patients, so patient selection should be carefully performed due to the toxicity of belotecan.

Topics: Aged; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Carcinoma; Cisplatin; Female; Humans; Neoplasm Recurrence, Local; Peritoneal Neoplasms; Peritoneum; Topoisomerase I Inhibitors; Treatment Outcome

To compare the efficacy and toxicity between topotecan- and belotecan-based chemotherapies in recurrent epithelial ovarian cancer (EOC).. The clinical data of 80 patients treated with topotecan- (n = 45) or belotecan- (n = 35) based chemotherapy as at least a second-line chemotherapy were reviewed retrospectively between July 2001 and December 2007. Response was evaluated using the Response Evaluation Criteria in Solid Tumours (RECIST) and serum CA-125 levels. Hematological toxicity was examined according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 2.0. Time to progressive disease (TTPD), chemotherapy-specific survival (CSS) and overall survival (OS) according to the 2 chemotherapies were evaluated by the Kaplan-Meier analysis with the log-rank test.. Overall response rate (ORR) was 24.4% in patients treated with topotecan-based chemotherapy, while it was 45.7% in those treated with belotecan-based chemotherapy (P = 0.046). Moreover, ORR was higher in platinum-sensitive patients treated with belotecan-based chemotherapy (58.8%) than those treated with topotecan-based chemotherapy (22.2%) (P = 0.041) although it was not significantly different in platinum-resistant patients (P = 0.471). Grade 3 or 4 anemia, neutropenia and thrombocytopenia developed in 14.8% vs 3.6%, 43.1% vs 55.6%, and 20.0% vs 12.8% of cycles in topotecan- and belotecan-based chemotherapies, respectively (P < 0.05). There were no significant difference in survival between the 2 chemotherapies.. In our experience, belotecan-based chemotherapy seemed to be efficient with acceptable toxicity, compared to topotecan-based chemotherapy in recurrent EOC. However, randomized controlled trials are required for the comparison of the efficacy and toxicity between topotecan- and belotecan-based chemotherapies in recurrent EOC.

Topics: Adult; Aged; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Carcinoma; Cisplatin; Epithelium; Female; Humans; Middle Aged; Neoplasm Recurrence, Local; Ovarian Neoplasms; Retrospective Studies; Survival Analysis; Topotecan