Epirubicin, Cisplatin and Capecitabine [Ecx] for Relapsed Epithelial Ovarian Cancer: Results of a Pilot Study

Abstract:: Background and Aims Epirubicin [E], Cisplatin [C], Carboplatin [Carbo], 5 Fluorouracil [F] or Capecitabine [X] have shown activity when given in combination (ECarboX/ECF) for relapsed epithelial ovarian cancer (rEOC), but are associated with significant toxicity. We aimed to determine tolerability and activity of ECX in rEOC, evaluate response rate [RR], progression free survival [PFS] and overall survival [OS] in patients [pts] with an initial platinum free interval [PFI] < or > 6 months (m). Methods Pts with rEOC treated using a 3 weekly schedule of E 50mg/m2, and C 50mg/m2 on day 1, with X 650mg/m2 bd (21 days [d] q 3 weeks [w]) or 1g/m2 bd 14d q 3w). Toxicities scored by CTCv3. Dose reductions for toxicity > G3. Results N = 33. Mean age = 60. Median cycles ECX = 5. Mean delivered dose intensity: 16mg/m2/w for E and C, 6998mg/m2/w for X. Overall RRs (CR + PR) = 62.5% (RECIST) and 84% (Ca125). Median PFS = 4m (4.8m PFI < 6m, 3.9m PFI > 6m). Median OS = 14m (11.6m PFI < 6 months, 17.3m PFI > 6 months). G3 toxicities; nausea 22.5%, vomiting 13%, fatigue 9%, diarrhoea 6%, infection 13%. G4 toxicities; neutropaenia 16%, nausea 3%, vomiting 10%. Treatment delays = 16. Admissions = 11. No treatment deaths. Conclusions ECX is an effective and tolerable treatment for rEOC even with PFI <6m, for whom it should be considered second line chemotherapy. In pre-treated rEOC patients we propose a 3 weekly schedule of 50mg/m2 E, 50mg/m C, and 650mg/m2 X on days 1-14.

Authors:: HM Hatcher, M Iddawela, J Abraham, CA Palmer, C Parkinson, J Pratt, HM Earl

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