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  • Articles: DFG German National Licenses  (4)
  • paclitaxel  (2)
  • adjuvant chemotherapy  (1)
  • nm23  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Long-term results from a phase II study of single agent paclitaxel (Taxol®) in previously platinum treated patients with advanced ovarian cancer: The Nordic experience (1998)
    Springer
    Annals of oncology 9 (1998), S. 1301-1307 
    Details
    ISSN: 1569-8041
    Keywords: advanced recurrent ovarian cancer ; paclitaxel ; second-line treament
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Owing to the wide spread perception of a possible benefit from paclitaxel in the second-line situation the Nordic Gynecologic Oncology Group (NGOG) conducted two prospective phase II studies of paclitaxel single agent treatment (175 mg/m2, three-hour i.v. infusion with standard pre-medication every third week) in patients with relapsing or progressing epithelial ovarian cancer following platinum. Patients and methods: Between 1992–1994 138 patients in total were enrolled of whom 136 received paclitaxel and were included in the toxicity and survival analysis, while 112 were evaluable for response. Results: The overall response rate (CR + PR) was 28% with 16 patients achieving a CR (14%). The estimated median (range) time to progression was 4.1 (0.7–60.7) months. The projected four-year overall survival was 7%, with a median (range) of 9.6 (0.3–60.7) months. A multivariate logistic regression analysis showed that platinum resistance, and WHO performance status at baseline, independently correlated with survival at all three time points (median survival time 9.6, 18, and 24 months). Patients with platinum sensitive tumors and WHO performance status 0 had a median survival of 25.6 months compared to 7.0 months for the rest of the patients (P ≤ 0.0001). No serious toxicity was registered. Conclusion: Paclitaxel could safely be administered in an outpatient setting using this schedule. Patients with platinum sensitive tumors and a good performance status were most likely to survive. However, these patients are also most likely to respond to re-treatment with a platinum compound. With reference to the reasonably good tumor control and limited toxicity observed in this study, we conclude that paclitaxel single agent therapy is a viable option in the salvage situation, which in some patients can give long-lasting responses. However, although responses can be induced in a significant number of patients, the survival figures remain poor.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008400324892
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Randomized study on adjuvant chemotherapy in stage I high-risk ovarian cancer with evaluation of DNA-ploidy as prognostic instrument (2000)
    Springer
    Annals of oncology 11 (2000), S. 281-288 
    Details
    ISSN: 1569-8041
    Keywords: adjuvant chemotherapy ; DNA ploidy ; early ovarian cancer ; intergroup prospective trials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose:Adjuvant chemotherapy versus observation and chemotherapyat progression was evaluated in 162 patients in a prospective randomizedmulticenter study. We also evaluated DNA-measurements as an additionalprognostic factor. Patients and methods:Patients received adjuvant carboplatin AUC7 every 28 days for six courses (n = 81) or no adjuvant treatment(n = 81). Eligibility included surgically staged and treated patientswith FIGO stage I disease, grade 1 aneuploid or grade 2 or 3 non-clear cellcarcinomas or clear cell carcinomas. Disease-free (DFS) and disease-specific(DSS) survival were end-points. Results:Median follow-up time was 46 months and progression wasobserved in 20 patients in the treatment group and 19 in the control group.Estimated five-year DFS and DSS were 70% and 86% in thetreatment group and 71% and 85% in the control group. The hazardratio was 0.98 (95% confidence interval (95% CI):0.52–1.83) regarding DFS and 0.94 (95% CI: 0.37–2.36)regarding DSS. No significant differences in DFS or DSS could be seen when thelog-rank test was stratified for prognostic variables. Therefore, data fromboth groups were pooled for the analysis of prognostic factors. DNA-ploidy(P = 0.003), extracapsular growth (P = 0.005), tumor rupture(P = 0.04), and WHO histologic grade (P = 0.04) weresignificant independent prognostic factors for DFS withP 〈 0.0001for the model in the multivariate Cox analysis. FIGO substage (P =0.01), DNA ploidy (P 〈 0.05), and histologic grade (P =0.05) were prognostic for DSS with a P-value for the model 〈0.0001. Conclusions:Due to the small number of patients the study wasinconclusive as regards the question of adjuvant chemotherapy. The survivalcurves were superimposable, but with wide confidence intervals. DNA-ploidyadds objective independent prognostic information regarding both DFS and DSSin early ovarian cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008399414923
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    The significance of metastasis-related factors cathepsin-D and nm23 in advanced ovarian cancer (1999)
    Springer
    Annals of oncology 10 (1999), S. 1335-1341 
    Details
    ISSN: 1569-8041
    Keywords: cathepsin-D ; nm23 ; ovarian cancer ; prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Different regulators or effectors of the metastatic cascade can be of prognostic and/or predictive significance. Cathepsin-D and nm23 operate at different levels of the metastatic process and have not yet been analyzed in combination in ovarian cancer. Patients and methods: The prevalence of cathepsin-D and nm23 expression was studied with immunohistochemistry in a cohort of 185 previously untreated cases of FIGO stage III ovarian cancer. Correlations with known prognostic factors were examined, and both uni- and multivariate survival analyses were performed. Results: Epithelial cell cathepsin-D expression was found in 58% of cases, stromal cell cathepsin-D expression in 20%, and nm23 expression in 72%. Epithelial cell cathepsin-D expression was positively correlated with better differentiation of the tumor tissue (P = 0.034). No correlation was found between epithelial and stromal cell cathepsin-D expression, but a striking degree of positive correlation was demonstrated between epithelial cell cathepsin-D and nm23 expression (P = 0.005). None of the factors studied was of any value in predicting the response to platinum and anthracyclin combination chemotherapy, as assessed by second look laparotomy. In univariate analysis age, FIGO substage, histological type, differentiation grade, ascites, residual disease and epithelial cathepsin-D were associated with corrected survival. Neither stromal cell cathepsin-D, nor nm23 expression were of prognostic significance. However, in multivariate analysis the combination of epithelial and stromal cell cathepsin-D expression (P = 0.030), residual disease (P = 0.002) and differentiation grade (P = 0.007) were the only remaining independent prognostic factors in this patient group. Conclusions: Our results support a favourable prognostic significance of cathepsin-D expression in advanced ovarian cancer, but underscore the importance of considering both epithelial and stromal cell expression. We could not confirm the prognostic significance of nm23 expression in the present cohort of advanced ovarian cancer patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008352502465
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Paclitaxel in untreated FIGO stage III suboptimally resected ovarian cancer (1997)
    Springer
    Annals of oncology 8 (1997), S. 803-806 
    Details
    ISSN: 1569-8041
    Keywords: advanced ovarian cancer ; first-line treatment ; paclitaxel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: We wanted to assess the efficacy and toxicity of paclitaxel(Taxol) in previously untreated patients with advanced ovarian cancer. Nosuch study had been performed at the time of initiation of this study. Patients and methods: The study population in this analysis consisted of35 previously untreated stage III ovarian cancer patients, suboptimallyresected at primary surgery. The initial paclitaxel dose was 175mg/m2 given as a three-hour i.v. infusion every three weeks. Results: A total of 225 paclitaxel courses were given to 35 patients ofwhom 34 were evaluable for clinical response. Nine (26%) patientsobtained a complete response to paclitaxel, ten (29%) a partialresponse, seven (21%) stable disease and eight (24%) hadprogressive disease. Thus, the total response rate to paclitaxel treatmentwas 55% (19 of 34). The median duration of response for the 19responding patients was eight months (range 1–44.5+). The medianduration for nine patients with clinical complete response was 16 months(range 2–44.5+). A second-look laparotomy was performed in 15 patients after six coursesof paclitaxel. Of these, five obtained a histopathologically completeremission, five a partial remission and five stable disease. The fivepatients with pathologically complete remissions are alive with a medianprogressive-free survival of 24.5 months (range 15+–44.5+). The medianprogression-free survival for all patients was 6.1 months (range1–44.5+). Toxicity consisted mainly of neutropenia, easily controlled.Other toxicities were myalgia/arthralgia and peripheral neuropathy. Threepatients experienced a severe anaphylactic reaction during the first course.Conclusion: This study showed that paclitaxel is an effective and safe drugfor first-line treatment of ovarian cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008230909599
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    Paper (German National Licenses)
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