A phase i study with an expanded cohort to assess the feasibility of intraperitoneal carboplatin and intravenous paclitaxel in untreated ovarian, fallopian tube, and primary peritoneal carcinoma: A Gynecologic Oncology Group study

Mark A. Morgan, Michael W. Sill, Keiichi Fujiwara, Benjamin Greer, Stephen C. Rubin, Koen Degeest, S. Diane Yamada, Steven Waggoner, Robert L. Coleman, Joan L. Walker, Robert S. Mannel

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Objective: This study aimed to determine the first-cycle maximum tolerated dose (MTD) of intraperitoneal carboplatin in combination with intravenous paclitaxel and then assess the feasibility of this dose over multiple cycles. Methods: Beginning at an intraperitoneal (IP) carboplatin dose area under the curve (AUC) of 5 and a fixed intravenous dose of 175 mg/m2 paclitaxel, patients were entered on a dose-escalating phase evaluating first-cycle dose-limiting toxicity (DLT). After estimating the MTD, cohorts of 20 patients were then entered in an expanded phase to evaluate DLT over four cycles. Results: Twenty-one patients were entered on the dose-escalating phase. A first-cycle MTD of carboplatin at AUC 8 was tolerated although thrombocytopenia was dose-limiting over multiple cycles. An additional 69 patients were treated in expanded cohorts. Only 5/90 (5.6%) patients discontinued treatment because of a port problem. Four-cycle DLT required de-escalation to a carboplatin AUC of 6, and even at that dose, there were 14 dose-limiting toxic effects in 40 patients (35%). Seven dose-limiting toxicities were due to neutropenia, and 6 were due to grade 3/4 thrombocytopenia. Six cycles of therapy were completed in 75% of eligible patients, but dose adjustments were required. Conclusions: The first-cycle MTD did not predict the tolerability of this regimen over multiple cycles. Using an IP carboplatin dose of AUC 6 in combination with paclitaxel, the regimen can be administered with a high completion rate over multiple cycles. Because neutropenia is a frequent DLT, the addition of hematopoietic growth factors may permit a high completion rate while maintaining this dose.

Original languageEnglish (US)
Pages (from-to)264-268
Number of pages5
JournalGynecologic oncology
Volume121
Issue number2
DOIs
StatePublished - May 1 2011

    Fingerprint

Keywords

  • Carboplatin
  • Chemotherapy
  • Intraperitoneal chemotherapy
  • Ovarian cancer
  • Phase I trial

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this