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Annals of Oncology Advance Access originally published online on June 19, 2009
Annals of Oncology 2009 20(11):1787-1793; doi:10.1093/annonc/mdp193
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

gynecologic tumors

A feasibility study of sequential doublet chemotherapy comprising carboplatin–doxorubicin and carboplatin–paclitaxel for advanced endometrial adenocarcinoma and carcinosarcoma

J. E. Ang1, R. N. Shah1, M. Everard1, C. Keyzor1, I. Coombes1, A. Jenkins2, K. Thomas1, R. A'Hern1, R. L. Jones1, P. Blake1, H. Gabra3, G. Hall2, M. E. Gore1 and S. B. Kaye1,*

1 Gynaecology Unit, Royal Marsden Hospital, London and Sutton, Surrey
2 Cancer Research UK Clinical Centre, St James University Hospital, Leeds
3 Department of Cancer Medicine, Hammersmith Hospital, London, UK

* Correspondence to: Prof. S. B. Kaye, Section of Medicine, Royal Marsden Hospital and Institute of Cancer Research, Sycamore House, Downs Road, Sutton, Surrey SM2 5PT, UK. Tel: +44-208-661-3539; Fax: +44-208-661-3541; E-mail: stan.kaye{at}rmh.nhs.uk

Background: Platinum compounds, taxanes and anthracyclines provide the major effective drug classes in the treatment of advanced and recurrent endometrial cancer and carcinosarcoma.

Patients and methods: A total of 52 women with advanced or recurrent endometrial cancer and carcinosarcoma were treated with four cycles of carboplatin area under the curve (AUC) 5 and doxorubicin (50 mg/m2) for four cycles before or after four cycles of carboplatin AUC5 and paclitaxel (175 mg/m2) with each cycle administered at 21-day intervals.

Results: Thirty-seven patients (71.2%) completed all planned treatment. Excluding six patients who did not complete treatment for non-drug-related causes, 80.4% completed all planned treatment. Three hundred and seventy-one treatment cycles were administered and 303 (81.7%) occurred on time. Common Toxicity Criteria grade 3/4 haematological toxic effects, particularly neutropenia and thrombocytopenia, were the predominant cause of treatment delays and dose reductions. A low incidence of grade 3 neurotoxicity and no cardiac toxicity were observed. The overall response rates for patients with evaluable disease were 82.1% and 66.7% for endometrial and carcinosarcoma, respectively. At a median follow-up of 21 months, the median progression-free survival for the endometrial adenocarcinoma and carcinosarcoma cohorts were 15.3 and 12.0 months, respectively.

Conclusion: This regimen is generally well tolerated with encouraging efficacy.

Key words: carboplatin, carcinosarcoma, doxorubicin, endometrial carcinoma, paclitaxel, sequential chemotherapy

Received for publication December 20, 2007. Revision received May 18, 2008. Revision received February 27, 2009. Accepted for publication March 6, 2009.


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