Cisplatin as initial chemotherapy in ovarian carcinosarcomas: a Gynecologic Oncology Group study

doi:10.1016/j.ygyno.2004.01.007

Gynecologic Oncology

Volume 93, Issue 2, May 2004, Pages 336-339

https://doi.org/10.1016/j.ygyno.2004.01.007 Get rights and content

Abstract

Objectives. Carcinosarcomas of the ovary are rare; hence, although most patients recur after surgical resection or have metastatic disease at the time of diagnosis, only anecdotal information is available concerning the activity of cytotoxic drugs against these lesions. The Gynecologic Oncology Group (GOG) initiated a concerted effort to study cytotoxic therapy for these cancers in 1976. This report presents data on cisplatin, the first of the agents to be studied in this disease.

Methods. One hundred thirty-six eligible patients with ovarian carcinosarcoma received cisplatin (50 mg/m²) every 3 weeks until disease progression or unacceptable toxicity.

Results. Among 44 patients evaluable for response, one complete (2%) and eight partial (18%) responses resulted. An additional 10 (23%) patients exhibited stable disease, while 25 (57%) had increasing disease. Median progression-free survival in 130 patients evaluable for this endpoint was 5.2 months. Median survival in the same 130 patients was 11.7 months. Adverse effects ≥grade 2 among the 132 patients evaluable for toxicity included leukopenia (14%), neutropenia (17%), thrombocytopenia (2%), anemia (10%), nausea and vomiting (40%), azotemia (3%), neurotoxicity (4%), fever (2%), and tinnitus (1%).

Conclusions. These data provide the first objective evidence that cisplatin is active as an initial therapy for patients who have carcinosarcoma of the ovary. The overall response rate (20%) is similar to that seen in carcinosarcomas of the uterus.

Introduction

Carcinosarcoma of the ovary is rare. Surgical resection has been the treatment of choice for those who have disease amenable to this modality. Only anecdotal information is available on the use of radiotherapy or chemotherapy in these patients. The following report presents the analysis of the largest series of carcinosarcomas of the ovary treated with a cytotoxic drug.

Section snippets

Materials and methods

Between April, 1977 and January, 1996, member institutions of the Gynecologic Oncology Group (GOG) entered 136 patients with carcinosarcoma of the ovary onto the study (Table 2). Patients were required to have histologically documented carcinosarcoma of the ovary, but measurable disease was not required. Pretreatment laboratory assessment must have included a leukocyte count >3000/μl, a neutrophil count >1500/μl, a platelet count >100,000/μl, a creatinine <2.0 mg/μl, and SGOT, alkaline

Results

The analysis of this trial included examination of several aspects: pretreatment characteristics of the patient population, assessment of response as well as progression-free and overall survival, and evaluation of toxicity.

Discussion

Carcinosarcomas are uncommon gynecologic cancers that occur principally in the uterus. In these uterine lesions, cytotoxic therapy has been extensively investigated by the GOG despite relative infrequency of occurrence. Agents identified as active (response rate ≥15%) include ifosfamide (32%)[1] and cisplatin (19%) [2], [3], [4]. Of note is the fact that doxorubicin demonstrated only a 10% response rate in a GOG study of uterine sarcomas [5]. The largest published series to date, which included

Acknowledgements

This study was supported by National Cancer Institute grants to the following Gynecologic Oncology Group member institutions that participated in this study: University of Alabama (CA 12484), Oregon Health Sciences University, Duke University Medical Center (CA 12534), Abington Memorial Hospital, University of Rochester Medical Center (CA 12482), Walter Reed Army Medical Center (CA 23501), Wayne State University (CA 12477), University of Minnesota Medical School (CA 23088), University of

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Citation Excerpt :
The achieved overall response rate was 17.9% in this cohort of patients with recurrent disease (Sutton et al., 1994). In the most recent GOG trial, among 136 patients, treated with cisplatin (50 mg/m2) every 3 weeks until disease progression or unacceptable toxicity, 44 were evaluable for treatment response (Tate Thigpen et al., 2004). One patient achieved a complete response, 8 experienced a partial response and 25 had progression of disease on the trial.
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¹: Currently: Vanderbilt University School of Medicine, Nashville, TN 37203.

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Cisplatin as initial chemotherapy in ovarian carcinosarcomas: a Gynecologic Oncology Group study

Abstract

Introduction

Section snippets

Materials and methods

Results

Discussion

Acknowledgements

Am. J. Obstet. Gynecol.

Phase II trial of cisplatin as first-line chemotherapy in patients with advanced or recurrent uterine sarcomas: a Gynecologic Oncology Group study

J. Clin. Oncol.

Phase II trial of cisplatin in the treatment of patients with advanced or recurrent mixed mesodermal sarcomas of the uterus: a Gynecologic Oncology Group study

Cancer Treat. Rep.

Cisplatin therapy for disseminated mixed mesodermal sarcoma of the uterus

J. Clin. Oncol.