The efficacy and safety of Oxaliplatin-Vinorelbine as a second-line chemotherapy combination in patients with platinum-resistant pretreated epithelial ovarian cancer: A retrospective study
Purpose: The main purpose of this study was to analyze the effects and tolerability of Oxaliplatin-Vinorelbine combination on Platinum-resistant epithelial ovarian carcinoma (EOC) patients.
Methods: A single centered retrospective study comprising of 34 patients was conducted, and all 34 patients were treated with Vinorelbine 30 mg/m2 on day 1 and 8 along with Oxaliplatin 100 mg/m2 on day 1 of 3 weeks treatment cycle following progressive platinum-resistant EOC.
Results: The combination showed an overall response rate (ORR) of 18% (95% CI, 4.4 - 31.6) where 2 (6%) patients had complete response and 4 (12%) patients had partial response. Stable disease was observed in 9 (26%) patients and progressive disease in 19 (56%) patients. Median diseases free survival, median relapse free survival and median time to progression was 17.05 months, 4.4 months, and 1.25 months, respectively. Hematological toxicities were mild; only 1 (2.9%) patient had G3 anemia and major non-hematological toxicities include nausea-vomiting, diarrhea, constipation, hepatotoxicity, fatigueness and alopecia, which are mainly limited to G1-G2 and reversible.
Conclusion: The effect of this combination is moderate as a second line treatment of platinum resistant EOC; however, in comparison with other regimens of Vinorelbine and Oxaliplatin, the activity is substandard but the toxicity profile is well tolerable. Further multicenter evaluation is needed for the better understanding of the therapeutic efficacy of the combination.
Miyake TM, Sood AK, Coleman RL. Contemporary use of bevacizumab in ovarian cancer. Expert Opin Biol Ther 2013; 13:283-94.
Poveda A, Ray-Coquard I, Romero I, et al. Emerging treatment strategies in recurrent platinum-sensitive ovarian cancer: focus on trabectedin. Cancer Treat Rev 2014; 40:366-75.
Della Pepa C, Banerjee S. Bevacizumab in combination with chemotherapy in platinum-sensitive ovarian cancer. OncoTargets and Therapy 2014; 7:1025-32.
Salah-Eldin MA, Wahba HA, Halim AA. Biweekly peglated liposomal doxorubicin/oxaliplatin for ovarian cancer resistant to taxane-platinum treatment: a Phase II study. Indian J Cancer 2012; 49:169-75.
Aravantinos G, Pectasides D. Bevacizumab in combination with chemotherapy for the treatment of advanced ovarian cancer: a systematic review. J Ovarian Res 2014; 7:57.
Leamon CP, Lovejoy CD, Nguyen B. Patient selection and targeted treatment in the management of platinum-resistant ovarian cancer. Pharmgenomics Pers Med 2013; 6:113-25.
Hasan J, Jayson GC. Oral melphalan as a treatment for platinum-resistant ovarian cancer. Br J Cancer 2003; 88:1828-30.
Warschkow R, Tarantino I, Lange J, et al. Does hyperthermic intraoperative chemotherapy lead to improved outcomes in patients with ovarian cancer? A single center cohort study in 111 consecutive patients. Patient Safety in Surgery 2012; 6:12.
Kothari R, Argenta P, Fowler J, et al. Antiestrogen therapy in recurrent ovarian cancer resulting in 28 months of stable disease: a case report and review of the literature. Arch Oncol 2010; 18:32-5.
Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009. CA Cancer J Clin 2009; 59:225-49.
Kikkawa F, Nawa A, Ino K, et al. Advances in treatment of epithelial ovarian cancer. Nagoya J Med Sci 2006; 68:19-26.
Kim A, Ueda Y, Naka T, Enomoto T. Therapeutic strategies in epithelial ovarian cancer. Journal of Experimental & Clinical Cancer Research 2012; 31:14.
Sugiyama T. Second-line chemotherapy for platinum- and taxane-resistant epithelial ovarian cancer: Pegylated Liposomal Doxorubicin (PLD), irinotecan, and combination therapies at lower doses. Ovarian Cancer - Clinical and Therapeutic Perspectives, Dr. Samir Farghaly (Ed.) 2012; 14: 275.
Lee HJ, Kim HS, Park NH, et al. Feasibility of Oxaliplatin, Leucovorin, and 5-Fluorouracil (FOLFOX-4) Chemotherapy in Heavily Pretreated Patients with Recurrent Epithelial Ovarian Cancer. Cancer Res Treat 2013; 45:40-7.
Markman M, Bookman MA. Second-Line Treatment of Ovarian Cancer. The Oncologist 2000; 5:26-35.
Bellati F, Napoletano C, Gasparri ML, et al. Monoclonal antibodies in gynecological cancer: a critical point of view. Clin Dev Immunol 2011; 2011:890758.
Mantia-Smaldone GM, Edwards RP, Vlad AM. Targeted treatment of recurrent platinum-resistant ovarian cancer: current and emerging therapies. Cancer Manag Res 2011; 3:25-38.
Tomao F, Papa A, Rossi L, et al. Current status of bevacizumab in advanced ovarian cancer. Onco Targets Ther 2013; 6:889-99.
Coleman RL, Monk BJ, Sood AK, Herzog TJ. Latest research and treatment of advanced-stage epithelial ovarian cancer. Nat Rev Clin Oncol 2013; 10:211-24.
Sabbatini P, Spriggs D. Salvage therapy for ovarian cancer. Oncology (Williston Park) 1998; 12:833-43.
Monnet I, de CH, Soulié P, et al. Oxaliplatin plus vinorelbine in advanced non-small-cell lung cancer: final results of a multicenter phase II study. Ann Oncol 2002; 13:103-7.
Faivre S, Kalla S, Cvitkovic E, et al. Oxaliplatin and paclitaxel combination in patients with platinum-pretreated ovarian carcinoma: An investigator-originated compassionate-use experience. Ann Oncol 1999; 10:1125-8.
Piccart MJ, Green JA, Lacave AJ, et al. Oxaliplatin or paclitaxel in patients with platinum-pretreated advanced ovarian cancer: A randomized phase II study of the European Organization for Research and Treatment of Cancer Gynecology Group. J Clin Oncol 2000; 18:1193-202.
Chollet P, Bensmaïne MA, Brienza S, et al. Single agent activity of oxaliplatin in heavily pretreated advanced epithelial ovarian cancer. Ann Oncol 1996; 7:1065-70.
Misset JL. Oxaliplatin in practice. Br J Cancer 1998; 77 Suppl 4:4-7.
Cattel L, Passera R, Katsaros D, et al. Pegylated liposomal doxorubicin and vinorelbine in recurrent ovarian carcinoma: a pharmacokinetic study on alternate administration sequences. Anticancer Res 2006; 26:745-50.
Katsaros D, Oletti MV, Rigault de la Longrais IA, et al. Clinical and pharmacokinetic phase II study of pegylated liposomal doxorubicin and vinorelbine in heavily pretreated recurrent ovarian carcinoma. Ann Oncol 2005; 16:300-6.
Bajetta E, Di Leo A, Biganzoli L, et al. Phase II study of vinorelbine in patients with pretreated advanced ovarian cancer: activity in platinum-resistant disease. J Clin Oncol 1996; 14:2546-51.
Tambaro R, Greggi S, Iaffaioli RV, et al. An escalating dose finding study of liposomal doxorubicin and vinorelbine for the treatment of refractory or resistant epithelial ovarian cancer. Ann Oncol 2003; 14:1406-11.
Gregory RK, Smith IE. Vinorelbine--a clinical review. Br J Cancer 2000; 82:1907-13.
Goa KL, Faulds D. Vinorelbine. A review of its pharmacological properties and clinical use in cancer chemotherapy. Drugs Aging 1994; 5:200-34.
Miller AB, Hoogstraten B, Staquet M, Winkler A. Reporting Results of Cancer Treatment. Cancer 1981; 47: 207-14.
Dogan NU, Schneider A, Chiantera V, et al. Tertiary cytoreduction in the setting of recurrent ovarian cancer (Review). Oncol Lett 2013; 6:642-47.
Harries M, Kaye SB. Recent advances in the treatment of epithelial ovarian cancer. Expert Opin Investig Drugs 2001; 10:1715-24.
Kakolyris S, Kouroussis C, Koukourakis M, et al. A dose-escalation study of oxaliplatin and vinorelbine in patients with advanced solid tumors. Oncology 2002; 63:213-8.
Sorensen P, Hoyer M, Jakobsen A, et al. Phase II study of vinorelbine in the treatment of platinum-resistant ovarian carcinoma. Gynecol Oncol 2001; 81:58-62.
Aravantinos G, Bafaloukos D, Fountzilas G, et al. Phase II study of docetaxel-vinorelbine in platinum-resistant, paclitaxel-pretreated ovarian cancer. Ann Oncol 2003; 14:1094-9.
Wang J, Han N, Wang HL, et al. Therapeutic effect of docetaxel combined with oxaliplatin for treatment of recurrent epithelial ovarian cancer. Nan Fang Yi Ke Da Xue Xue Bao 2009; 29:2319-20.
Xenidis N, Neanidis K, Amarantidis K, et al. Biweekly vinorelbine and gemcitabine as second-line and beyond treatment in ovarian cancer. Cancer Chemother Pharmacol 2011; 67:69-73.
Vici P, Sergi D, Pizzuti L, et al. Gemcitabine-oxaliplatin (GEMOX) as salvage treatment in pretreated epithelial ovarian cancer patients. J Exp Clin Cancer Res 2013; 32:49.
This work is licensed under a Creative Commons Attribution 3.0 License.
International Journal of Cancer Therapy and Oncology (ISSN 2330-4049)
© International Journal of Cancer Therapy and Oncology (IJCTO)
To make sure that you can receive messages from us, please add the 'ijcto.org' domain to your e-mail 'safe list'. If you do not receive e-mail in your 'inbox', check your 'bulk mail' or 'junk mail' folders.