Carcinoma ovarico: trattamento medico di II linea

Nell’ottobre 1990 é stato avviato uno studio sul carcinoma ovarico.

Lo studio (Protocollo 90/4) aveva l’obiettivo di valutare l’efficacia dell’associazione ifosfamide+mitoxantrone in termini di risposte obiettive e loro durata in pazienti resistenti o recidivati dopo la terapia di I linea contenente cisplatino e di stabilire la fattibilità e la tollerabilità della terapia proposta.

Sono state arruolate 72 pazienti.

Lo studio ha dimostrato che la combinazione dei due farmaci sperimentali non può essere considerata una terapia “standard” nel carcinoma ovarico pretrattato con platino-derivati. E’ stato possibile identificare, sulla base di dati clinici e biologici, due distinte categorie di pazienti diversamente suscettibili al trattamento chemioterapico proposto.

Centri partecipanti :                     Ospedale Maggiore di CREMONA

Osp. Oncologico di CAGLIARI

Ospedale di BORGO S. LORENZO (FI)

Ospedale di GAVARDO (BS)

Ospedale San Pier D’Arena, GENOVA

Ospedale C. Poma, MANTOVA

Istituto Nazionale Tumori – OMB, MILANO

Ospedale Ramazzini, MODENA

Istituto Tumori Fondazione Pascale, NAPOLI

Ospedale S. Gennaro, NAPOLI

Policlinico di PALERMO

Ospedale degli Infermi, RIMINI (FO)

Osp. Addolorata di ROMA

Ospedale Civile di TREVISO

Ospedale Civile di THIENE (VI)

Riferimenti Bibliografici:

  • Mitoxantrone and ifosfamide as second-line therapy of epithelial ovarian cancer. A pilot study by the I.T.M.O. Group.
    (Di Leo A, Bajetta E, Biganzoli L, Bohm S, Lupi G, Oriana S, Riboldi G, Spatti G, Zunino F, Di Re F).
    Eur J Cancer. 1994;30A(14):2188.

PMID: 7857726   [PubMed – indexed for MEDLINE]

Download articolo: Eur. J. Cancer 30A – 2188, 1994

  • An I.T.M.O. group study on second-line treatment in advanced epithelial ovarian cancer: an attempt to identify clinical and biological factors determining prognosis.
    (Di Leo A, Bajetta E, Biganzoli L, Bohm S, Mariani L, Mènard S, Pilotti S, Fabbiani M, Gebbia V, Oriana S, et al.).
    Eur J Cancer. 1995 Dec;31A(13-14):2248-54.

 

Abstract

The aim of the present study was to determine the activity of a combined regimen of mitoxantrone (DHAD) and ifosfamide (IFO) and identify clinical and biological factors with prognostic importance for the second-line treatment of ovarian cancer. The following factors were investigated for their prognostic importance: age, disease sites, platinum responsiveness, histological grade, the presence of clinically/radiologically detectable versus not detectable disease, residual disease volume after first surgery, p53 protein, c-erbB-2 oncoprotein and laminin receptor. 72 patients entered the trial. DHAD and IFO therapy led to a 15% response rate among the 47 cases with clinically/radiologically detectable disease (1 complete and 6 partial responses), with a median response duration of 4 months. The response rate was significantly different according to platinum responsiveness (4% objective responses in platinum-resistant versus 27% in platinum-sensitive disease). The time to treatment failure (TTF) and overall survival (OS) were affected by the presence of clinically detectable disease at study entry (median TTF 4 months in the presence of clinically/radiologically detectable disease versus 9 months if the disease was not similarly detectable, P = 0.02; median OS 10 months versus 21 months, P = 0.01). Initially overexpressed in only a few tumours, the c-erbB-2 oncoprotein became overexpressed in 36% of platinum-resistant tumours; this modulation did not occur in platinum-sensitive tumours. Furthermore, laminin receptor was expressed in 77% of platinum-sensitive versus 39% of platinum-resistant patients. There were no differences in p53 protein expression according to drug responsiveness.

PMID: 8652251 [PubMed – indexed for MEDLINE]

Download articolo: Eur. J. Cancer 1995