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Biweekly 72-Hour 9-Aminocamptothecin Infusion As Second-Line Therapy for Ovarian Carcinoma: Phase II Study of the New York Gynecologic Oncology Group and the Eastern Cooperative Oncology Group

From the New York University School of Medicine; Roosevelt Hospital; Mt Sinai School of Medicine; and New York-Cornell Hospital Center, New York, NY; and the Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD.

Address reprint requests to Howard Hochster, MD, New York University School of Medicine, 160 E 32nd St, New York, NY 10016; e-mail: howard.hochster{at}med.nyu.edu

PURPOSE: To determine the antitumor activity of the novel topoisomerase I inhibitor 9-aminocamptothecin (9-AC) given over 72 hours every 2 weeks in patients with ovarian carcinoma previously treated with one platinum-containing regimen.

PATIENTS AND METHODS: Patients with ovarian carcinoma who received one prior platinum-containing regimen were eligible. Patients were stratified based on whether their disease was measurable, or nonmeasurable but assessable. 9-AC 35 µg/m²/h was administered by continuous infusion for 72 hours every 2 weeks via ambulatory pump.

RESULTS: Sixty patients were entered, 32 with measurable and 28 with nonmeasurable but assessable disease. Ten (16.7%) of 60 patients responded (95% CI, 7.2% to 26.1%), with four complete responses and six partial remissions. The response rate for patients with measurable and nonmeasurable but assessable disease was 22% (95% CI, 7.6% to 36.2%) and 10.7% (95% CI, 2.3% to 28.2%), respectively. None of the responders were platinum-resistant. Nineteen patients (32%) had stable disease. The major toxicities were hematologic, with 25% of patients having grade 3 and 35% having grade 4 neutropenia, including five episodes of febrile neutropenia, 17% having grade 3 to 4 thrombocytopenia, and 27% having grade 3 to 4 anemia. Nonhematologic toxicity included grade 3 to 4 nausea (27%) and grade 3 to 4 vomiting (12%).

CONCLUSION: This phase II multicenter trial of biweekly 72 hour 9-AC infusion as second-line therapy for ovarian cancer demonstrates comparable activity to standard approved agents in patients with both measurable and nonmeasurable but assessable disease. Toxicity consists mainly of moderate but controllable myelosuppression. Further studies combining 9-AC with other agents active in ovarian cancer for use as second-line therapy are warranted.

This study was conducted in conjunction with the Eastern Cooperative Oncology Group and supported in part by Public Health Service grant No. CA21115 and grant Nos. CA16087, CA76642, CA21115(-27), N01-CM-07003-74S from the National Cancer Institute, National Institutes of Health, and the Department of Health and Human Services, Bethesda, MD.

Presented in part at the 35th Annual Meeting of the American Society of Clinical Oncology, Atlanta, GA, May 15-18, 1999.

The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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