It is well known that recurrent and metastatic endometrial and ovarian cancers are especially difficult to treat. Because patients have typically already undergone significant treatment, their tumors tend to develop resistance to chemotherapy drugs. “Women with recurrent gynecologic cancers have often had multiple rounds of chemotherapy, which can cause tumor cells to develop resistance to these drugs,” says Mark H. Einstein, M.D., lead study researcher and associate professor of obstetrics and gynecology and women’s health at Einstein. “This resistance can make it difficult for doctors to devise a treatment protocol that will impact the cancers while avoiding the often severe side effects that certain chemotherapy drugs can cause, particularly when patients have already been heavily pretreated with other anti-cancer drugs.”
Dr. Einstein and his colleagues conducted a phase 2 trial to evaluate the effectiveness of using a combination of two chemotherapy drugs – topotecan and docetaxel – to treat these cancers. In past clinical trials, both had been shown to be effective when used separately to treat recurrent gynecologic cancers. The trial involved 24 women with one of four types of cancers, all recurrent: uterine, ovarian, fallopian or peritoneal cancer. The women underwent a total of six treatment cycles in which the topotecan-docetaxel combination was given on the first day of the study, followed by weekly treatments for three weeks and no treatment for the fourth week. Although the majority of the study participants had already been “heavily pretreated” with chemotherapy, close to 40 percent had a clinical benefit. And when compared to the previous trials, an unusually high proportion experienced few and relatively mild side effects. Moreover, the overall survival rate of 18.5 months for the women taking the combination therapy was higher than in the previous studies. As Dr. Einstein noted in the journal Gynecologic Oncology, which published the study findings, “The trial’s effectiveness and safety outcomes are promising enough to justify a larger clinical study of this drug combination for women with recurrent gynecologic cancers.”
News Release: New treatment shows promise against recurrent gynecologic cancers www.eurekalert.org April 21, 2009
