According to an article recently published in the International Journal of Gynecologic Oncology, three treatment regimens consisting of high-dose chemotherapy and autologous stem cell transplantation appear promising for the treatment of patients with ovarian cancer that has stopped responding to standard therapies.
Since ovarian cancer tends to be diagnosed at a late stage (once the cancer has spread), it is one of the most deadly gynecologic cancers. Once the cancer has spread, it is difficult to cure. And, even though advanced ovarian cancer (cancer that has spread from the ovary to other sites in the body) may respond to initial therapy, it often recurs (recurrent ovarian cancer).
Patients with recurrent ovarian cancer have poor long-term outcomes with standard treatment approaches. Researchers continue to evaluate new chemotherapy combinations and therapeutic approaches in order to improve the duration of survival and/or quality of life for these patients.
Researchers from New York University recently conducted a trial to evaluate a treatment approach consisting of three regimens of high-dose chemotherapy and autologous stem cell infusion.
High-dose chemotherapy is used to kill more cancer cells than standard doses. However, high-dose therapy has the common side effect of low levels of blood cells; low levels of blood cells may result in life-threatening complications, such as infection, anemia, or bleeding. In order to treat low blood cell levels, physicians collect hematopoietic stem cells (immature blood cells) from the patient prior to treatment. The stem cells are then frozen and infused into the patient following therapy (autologous stem cell transplant). This restores blood cells to acceptable levels following high-dose therapy.
The recent trial included 17 patients with ovarian cancer who had stopped responding to standard therapies. Patients were treated with three regimens of high-dose therapy, each followed by the infusion of stem cells. Patients also received Neupogen® (filgrastim), which is an agent that stimulates the body to produce white blood cells.
- Complete disappearances of detectable cancer occurred in 36% of patients.
- Partial disappearances of detectable cancer occurred in 14% of patients.
- Disease stabilization occurred in 29% of patients.
- Median progression-free survival was 7 months.
- Median overall survival was 18 months.
- The main side effect was mucositis (inflammation, ulceration of the lining of the mouth), which occurred in 44% of patients.
- There were no treatment-related deaths.
The researchers concluded that sequential regimens of high-dose chemotherapy followed by stem cell infusion appears promising for women with ovarian cancer that has stopped responding to standard therapies. Further studies are warranted to evaluate different chemotherapy regimens and doses for this group of patients.
Patients with ovarian cancer that has stopped responding to standard therapies may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating high-dose therapy or other novel therapeutic options. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.
Reference: Phase I/II study of tandem cycles of high-dose chemotherapy followed by autologous hematopoietic stem cell support in women with advanced ovarian cancer. International Journal of Gynecological Cancer. 2006;16:57-64.