Intraperitoneal carboplatin in the treatment of minimal residual ovarian cancer

Citations from the Literature after the initially elevated serum CA 125 measurement and 15 months after the first measured doubling of that level. Because no other malignancies were identified at entry or during the follow-up period (median 560 days) in the women with elevated CA 125 levels, the specificity of the assay over that time period would have been 99.9% using the doubling of an initially elevated value as the criterion for determining positivity and 100% using as the criterion a sustained increase in the level for those with initially elevated levels that doubled. These results support the continued investigation of longitudinally collected CA 125 levels to identify indivdiuals at high risk for ovarian malignancy. Intraperitoaeal carboplatin in the treatment of minimal residual ovarian cancer Pfeiffer P; Bennedbaek 0; Bertelsen K Department of Oncoiogy R, Odense Unversity Hospital, Odense, DNK GYNECOL ONCOL 1990,36/3 (306-311) Thirty-one ovarian cancer patients with minimal residual disease after intravenous cisplatin combination chemotherapy were treated with intraperitoneal carboplatin (IP-Ca). The dose of IP-Ca was escalated from 150 to 350 mg/m*. Twenty-two patients received at least three courses of IP-Ca and were evaluable for efficacy. Third-look laparotomy was done in 10 patients. Two patients obtained a complete pathological response (CPR) lasting 33 + and 41 + months, respectively; 8 patients had minimal residual disease. Median survival for all patients was 14 + months. All patients were eligible for toxicity. Maximum tolerable dose in these heavily pretreated patients was 300 mg/m2 IP-Ca. The dose-limiting toxicity was thrombocytopenia; in 27% of the patients who received 350 mg/m* IP-Ca, WHO grade 4 thrombocytopenia was seen. No patient had WHO grade 4 leukopenia. Subjective side effects consisted of mild nausea and vomiting (WHO). In conclusion, IP-Cacan produce CPR in heavily pretreated patients with only minor side effects. Cis-pIntinum/vinblastine/bleomycin combination chemotherapy in advanced or recurrentgranulosa cell tumors of the ovary Zambetti M; Escobedo A; Pilotti S; De Palo G Divsion of Medical Oncology, Istituto Nazionale Tumori, Milan, ITA GYNECOL ONCOL 1990,36/3 (317-320) Seven consecutive patients with advanced/recurrent granulosa cell tumors were treated with or VB (cis-platinum, 20 mg/ m*, Days l-5; vinblastine, 6 mg/m”, Days 1 and 2; and bleomycin, 18 mg/m*, Days 2, 9, and 16). The median age at the start of PVB treatment was 53 years (15-57); three patients had stage III disease and four presented with abdominal recurrences. Prior to PVB, all but one patient underwent surgical treatment, and in six patients gross residual disease was documented. No patient received prior chemotherapy or radiotherapy. The median number of PVB cycles was 5. Three complete (one pathologically documented) and one partial response were observed, for an overall responsive rate of 66%. Two complete responders were alive without evidence of disease 7 and 26

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months from the start of treatment; the remaining patient relapsed at 15 months. Two patients progressed during treatment, and one died because of sepsis in a granulocytosis. Signs of peripheral neurotoxicity were documented in three patients. The present data confirm the therapeutic activity of the PVB regimen in advanced/recurrent granulosa cell tumors, but the cost/benefit ratio should be clearly assessed. Effective chemotherapy consisting of bleomycin, vincristine, mitomycin C, and cisplatin (BOMP) for a patient with in operable vulvar cancer Shimizu Y; Hasumi K; Masubuchi K Department of Gynecology, Cancer Institute Hospital, 1-37-l Kami-ikebukuro, Toshima-ku, Tokyo 170, JPN GYNECOL ONCOL 1990,36/3 (423-427) Combination chemotherapy consisting of bleomycin, vincristine, mitomycin C, and cisplatin (BOMP) was first applied to an inoperable case (57-year-old) with FIG0 stage IV (T3N3 + MlB) squamous cell carcinoma of the vulva. After three courses of BOMP therapy, the patient achieved a complete response with few toxic effects and subsequently could undergo radical vulvectomy with bilateral inguinal and pelvic lymphadenectomy. On microscopic examination, only a minute focus of viable squamous cell carcinoma was observed in the vulvar lesion and regional lymph nodes, which was surrounded by fibrotic or necrotic tissues. The patient received a further two courses of BOMP as postoperative chemotherapy. Five courses of BOMP were extremely tolerable and did not require special care. She has been free of disease for 20 months and her present performance status is 0. The encouraging result warrants the use of this combination chemotherapy regimen in other patients with advanced squamous cell carcinoma of the vulva. Carboplatin therapy in advanced endometrial cancer Green JB III; Green S; Alberts DS; O’Toole R; Surwit EA; Noltimier JW Southwest Oncology Group, Operations Office, 5430 Fredericksburg Road, San Antonio, TX 78229-6197. USA OBSTET GYNECOL 1990,75/4 (696-700) A phase II study of the effectiveness and toxicity of carboplatin in the treatment of metastatic or locally advanced endometrial cancer was carried out by the Southwest @neology Group. Thirty-two patients were registered in the study and 23 were fully evaluable for response and toxicity. Carboplatin was administered in a dose of 400 mg/m* at 28-day intervals without concomitant hydration if blood counts had recovered sufficiently. There were seven responses (two complete and five partial responses) among the 23 evaluable patients, for an overall reponse rate of 30%. Four (two of two complete responders and two of five partial responders) of the seven responding patients remain alive at 839 + to 987 + days from the start of therapy. The two complete responders and one of the partial responders had small-volume disease, which may have contributed to their prolonged survival. Myelo suppression was the most prominent toxicity encountered. Seventeen of 27 patients evaluable for toxicity developed platelet counts of less than 75 X lo) CCLduring therapy, but no hemorrhagic complications Int J Gynecol Obstet 34