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SHR Neuro Cancer Cardio Lipid Metab Microb
Lee, CK; Gurney, H; Brown, C; Sorio, R; Donadello, N; Tulunay, G; Meier, W; Bacon, M; Maenpaa, J; Petru, E; Reed, N; Gebski, V; Pujade-Lauraine, E; Lord, S; Simes, RJ; Friedlander, M.
Carboplatin-paclitaxel-induced leukopenia and neuropathy predict progression-free survival in recurrent ovarian cancer.
BRIT J CANCER. 2011; 105(3): 360-365.
Doi: 10.1038/bjc.2011.256
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- Co-authors Med Uni Graz
- Petru Edgar
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- Abstract:
- BACKGROUND: We assess the prognostic value of chemotherapy-induced leukopenia and sensory neuropathy in the CALYPSO trial patients treated with carboplatin-paclitaxel (CP) or carboplatin-liposomal doxorubicin (CPLD). METHODS: We performed a landmark analysis at first month after randomisation to correlate leukopenia (nadir white blood cell < 4.0 x 10(9) per litre or severe infection) during cycle 1 of chemotherapy with progression-free survival (PFS). Using time-dependent proportional-hazards models, we also investigated the association between neuropathy and PFS. RESULTS: Of 608 patients with nadir blood and did not receive growth factors, 72% (CP 70%, CPLD 73%) had leukopenia. Leukopenia was prognostic for PFS in those receiving CP (adjusted hazard ratio (aHR) 0.66, P = 0.01). Carboplatin-liposomal doxorubicin was more effective than CP in patients without leukopenia (aHR 0.51, P = 0.001), but not those experiencing leukopenia (aHR 0.93, P = 0.54; interaction P = 0.008). Of 949 patients, 32% (CP 62%, CPLD 28%) reported neuropathy during landmark. Neuropathy was prognostic for PFS in the CP group only (aHR 0.77, P = 0.02). Carboplatin-liposomal doxorubicin appeared to be more effective than CP among patients without neuropathy (aHR 0.70, P < 0.0001), but not those with neuropathy (aHR 0.96, P = 0.81; interaction P = 0.15). CONCLUSION: First-cycle leukopenia and neuropathy were prognostic for patients treated with CP. Efficacy of CP treatment was similar to CPLD in patients who developed leukopenia. These findings support further research to understand the mechanisms of treatment-related toxicity. British Journal of Cancer (2011) 105, 360-365. doi:10.1038/bjc.2011.256 www.bjcancer.com Published online 12 July 2011 (C) 2011 Cancer Research UK
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Antineoplastic Combined Chemotherapy Protocols - adverse effects
- Carboplatin - adverse effects
- Doxorubicin - administration and dosage
- Female -
- Granulocyte Colony-Stimulating Factor - administration and dosage
- Humans -
- Leukopenia - chemically induced
- Male -
- Ovarian Neoplasms - drug therapy
- Paclitaxel - adverse effects
- Peripheral Nervous System Diseases - chemically induced
- Prognosis -
- Recurrence -
- Find related publications in this database (Keywords)
- leukopenia
- neuropathy
- ovarian cancer
- prognosis
- prediction