A pilot study of topotecan in the treatment of serous carcinoma of the uterus

Joseph T. Chambers, T. J. Rutherford, P. E. Schwartz, M. L. Carcangiu, S. K. Chambers, L. Baker

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

A pilot study investigated topotecan (Hycamtin, GlaxoSmithKline, Philadelphia, PA), a topoisomerase I inhibitor, in treating uterine serous carcinoma, a typically unresponsive aggressive tumor. Fifteen patients were surgically staged, then treated with topotecan (1.5 mg/m2, Days 1-5 every 21 days) as first-line therapy (n = 12) or secondary to platinum failure (n = 3). Patients received topotecan through six courses, disease progression, or unacceptable toxicity. Grade 3/4 hematologic toxicity prompted dose adjustments. Thirteen patients exhibited no gross evidence of residual disease postoperatively. At topotecan initiation, one patient had 5-cm and one had < 1-cm residual disease. Seventy-eight courses (median, six) were administered; 12 (80%) patients completed the specified protocol. Common serious toxicities included grade 3 neutropenia (33%), anemia (13%), and thrombocytopenia (13%). Eight patients received erythropoietin and/or granulocyte colony-stimulating factor. Median follow-up for 14 evaluable patients was 26 months (range, 13-40). Of 11 evaluable first-line topotecan patients, nine were alive at follow-up; five were disease-free. Of three second-line topotecan patients, two died and one was alive with disease 31 months post-treatment. One patient with measurable disease achieved a complete and one a partial response as assessed by computed tomography scan. Median progression-free survival was 25 months; median survival has not been reached at 26 months. Although topotecan's antitumor activity cannot yet be quantified, disease-free interval and survival outcomes compare favorably with other therapies in uterine serous carcinoma. Further evaluation of topotecan in this population is warranted.

Original languageEnglish (US)
Pages (from-to)216-222
Number of pages7
JournalInternational Journal of Gynecological Cancer
Volume13
Issue number2
DOIs
StatePublished - Mar 1 2003
Externally publishedYes

Keywords

  • Hycamtin
  • Myelosuppression
  • Topoisomerase I inhibitor
  • Topotecan
  • Uterine serous carcinoma

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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