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| |  SGO: Weekly Docetaxel and Carboplatin Effective and Well Tolerated in Recurrent Ovarian and Peritoneal Cancer By Karla Harby MIAMI BEACH, FL -- March 21, 2005 -- Weekly administration of combination docetaxel and carboplatin appear to be effective and well tolerated in patients whose carcinoma of the ovary or peritoneum has reoccurred, researchers reported at the 2005 Annual Meeting on Women’s Cancer of the Society of Gynecologic Oncologists. The investigators also found that giving patients diphenhydramine (Benadryl) 50 mg eliminated nearly all allergic reactions to carboplatin in their study. David M. Kushner, MD, assistant professor of gynecologic oncology, University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin, United States, presented his findings in a poster session here on March 20th. The overall response rate to weekly combination therapy was 68%, on the "very high end" of response rate reports, which tend to range from 50% to 70%, Dr. Kushner said in an interview. Dr. Kushner said that when the investigators started seeing carboplatin hypersensitivity reactions among patients in the study -- 7 occurred in 72 doses -- he asked a knowledgeable friend for advice, and was told to "give a bit of Benadryl." Out of the 193 doses of carboplatin administered along with 50 mg of diphenhydramine, there were two hypersensitivity reactions (1%, P <.01). So far, Dr. Kushner said his team has enrolled 36 subjects in this ongoing, phase 2 trial, and he reported on the 33 subjects with evaluable toxicities. Three of these patients had peritoneal cancer, and 30 had ovarian cancer. All had prior platinum-based chemotherapy, and were treatment free for at least 3 months after their initial therapy. All patients also had measurable or biologically evaluable disease, and neuropathy no greater than grade 2. On days 1, 8, and 15 of each 28-day cycle, the investigators administered docetaxel 35 mg/m2 over 1 hour; women with grade 2 neuropathy received 30 mg/m2. Patients also received carboplatin area under the curve (AUC) = 2 over 30 minutes (Calvert formula). The investigators initially pre-medicated patients with oral dexamethasone (4 mg x 3 doses) every 12 hours on days 1 and 0, and later amended this to include the Benadryl. Dr. Kushner said this study was designed to explore weekly administration of docetaxel and carboplatin, which to his knowledge has not been previously reported. Because docetaxel appears to cause less neuropathy than its sibling drug, paclitaxel, the investigators hoped the protocol would be safe. They did not anticipate the high rate of carboplatin hypersensitivity observed initially, but otherwise toxicities were uncommon and manageable, he said.
[Presentation title: Phase II Trial of Weekly Docetaxel and Carboplatin for Recurrent Ovarian and Peritoneal Cancer: Preliminary Results Including Prevention of Carboplatin Hypersensitivity. Abstract 77]
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