Nedaplatin and irinotecan combination therapy is equally effective and less toxic than cisplatin and irinotecan for patients with primary clear cell adenocarcinoma of the ovary and recurrent ovarian carcinoma

Abstract

This study retrospectively compared nedaplatin and irinotecan hydrochloride (NDP/CPT) combination therapy with cisplatin and irinotecan hydrochloride therapy (CDDP/CPT) for efficacy and adverse events in the treatment of clear cell adenocarcinoma of the ovary (CCC) and recurrent ovarian carcinoma. A total of 115 patients were included in the present study. NDP/CPT was administered intravenously every 4 weeks (NDP, 60 mg/m(2) on day 1; CPT, 50 mg/m(2) on days 1, 8 and 15). CDDP/CPT was also administered intravenously (CDDP, 60 mg/m(2) on day 1; CPT, 60 mg/m(2) on days 1, 8 and 15). Patients with primary CCC were treated with NDP/CPT in 29 cases and CDDP/CPT in 20 cases. Patients with recurrent ovarian carcinoma were treated with NDP/CPT and CDDP/CPT in 33 cases each. No significant difference was observed in the 5-year overall survival (OS)/progression-free survival (PFS) of patients with primary CCC, with the exception of those patients with stages Ia and Ic(b) who underwent NDP/CPT and CDDP/CPT treatments (OS: 58%, PFS: 40% and OS: 53% and PFS: 47%, respectively). No significant differences were found in the response rates to NDP/CPT and CDDP/CPT in patients with recurrent ovarian carcinoma (27 and 18%, respectively). Similarly, there were no significant differences in the 5-year OS and PFS of patients with recurrent ovarian carcinoma treated with NDP/CPT or CDDP/CPT (OS: 15%, PFS: 3% and OS: 18%, PFS: 6%, respectively). In terms of the hematological toxicity of grade 3 or above and non-hematological toxicity of grade 2 or above in patients treated with NDP/CPT and CDDP/CPT, respectively, neutropenia was 23 and 56%; anemia, 1, and 20%; thrombocytopenia, 0 and 5%; nausea, 20 and 52%; diarrhea, 14 and 25%; and fever, 2 and 11%. Accordingly, NDP/CPT indicated mild toxicity, and was therefore equally effective and less toxic than CDDP/CPT in the treatment of primary CCC and recurrent ovarian carcinoma.

Figure 1

Overall survival (OS) of patients with primary CCC, excluding those with stages Ia and Ic(b). The 5-year OS is 58% in patients treated with NDP/CPT and 53% in those treated with CDDP/CPT. No significant difference was observed.

Figure 2

Progression-free survival (PFS) of patients with primary CCC, excluding those with stages Ia and Ic(b). The 5-year PFS is 40% in patients treated with NDP/CPT and 47% in those treated with CDDP/CPT. No significant difference was observed.

Figure 3

Overall survival (OS) of recurrent ovarian carcinoma. The 5-year OS is 15% in patients treated with NDP/CPT and 18% in patients treated with CDDP/CPT. No significant difference is observed. The median OS in the two groups is 19 months. No significant difference was observed.

Figure 4

Progression-free survival (PFS) of recurrent ovarian carcinoma. The 5-year PFS is 3% in patients treated with NDP/CPT and 6% in patients treated with CDDP/CPT. No significant difference was observed. The median PFS is 6 months in patients treated with NDP/CPT and 4 months in patients treated with CDDP/CPT. No significant difference was observed.