Salvage Chemotherapy in Recurrent Platinum-Resistantor Refractory Epithelial Ovarian Cancer with Carboplatinand Distearoylphosphatidylcholine Pegylated LiposomalDoxorubicin (Lipo-Dox®)

Background: To evaluate the efficacy and safety of distearoylphosphatidylcholine pegylated liposomaldoxorubicin (DPLD) combined with carboplatin for the treatment of platinum resistant or refractory epithelialovarian cancer (EOC) or fallopian tube cancer. Materials and
Methods: A retrospective analysis of women whoreceived DPLD with carboplatin for recurrent EOC or fallopian tube cancer in King Chulalongkorn MemorialHospital Thailand from January 2006 to August 2011 was conducted. Patients were identified from the medicalrecords and data on demographic factors, stage, histology, surgical findings, cytoreduction status, and priorchemotherapies were abstracted. The efficacy and toxicity of DPLD/carboplatin were evaluated. Progression-free(PFS) and overall survival (OS) were estimated by the Kaplan-Meier method.
Results: A total of 65 patients, 64with platinum resistant or refractory epithelial ovarian cancer and 1 with fallopian tube cancer, were enrolled.DPLD and carboplatin were given for an average of 4.46 cycles per patient with a total of 273 cycles. Amongthe 65 evaluable patients, 0% achieved CR, 7.69% PR, 15.4% SD and 76.% PD. The overall response rate was23.1%. With a median follow-up of 27.4 months, the median progression-free and median overall survival inthe 36 patients was 4.46 months and 8.76 months respectively. In the aspect of side effects, palmar-plantarerythrodysesthesia (PPE) occurred in 33.3% (Grade I 22.2%, Grade II 11.1%) and mucositis in 41.7% (GradeI 27.8%, Grade II 13.9%) of all treatment cycles, all Grade 1 or 2. Anemia, leukopenia and thrombocytopeniaoccurred in 58.3% (Grade I 41.7%, Grade II 16.7%), 66.7% (Grade I 47.2%, Grade II 19.4%), and 22.2%(Grade I 16.6%, Grade II 5.56%) of cycle respectively, and were mostly Grade 1 or 2.
Conclusions: DPLD,the second-generation PLD drug combined with carboplatin every 4 weeks, is effective and has low toxicity fortreatment of patients with recurrent platinum-resistant or refractory epithelial ovarian cancer.