Efficacy evaluation of albumin-bound paclitaxel combined with carboplatin as neoadjuvant chemotherapy for primary epithelial ovarian cancer

Huan Wang, Lingyun Fan, Xia Wu, Yimin Han, Huan Wang, Lingyun Fan, Xia Wu, Yimin Han

Abstract

Objective: This study aimed to compare the efficacy of albumin-bound paclitaxel combined with carboplatin (Nab-TC) with that of traditional solvent-based paclitaxel combined with carboplatin (TC) as neoadjuvant chemotherapy (NAC) regimens for primary epithelial ovarian cancer.

Methods: Eighty patients with advanced primary epithelial ovarian cancer admitted for treatment at the Harbin Medical University Cancer Hospital from January 2015 to January 2020 were retrospectively selected. All patients underwent surgery after 1-4 courses of NAC with Nab-TC or TC regimen. Among the patients included for study, 40 patients in each group.

Results: The ORR in Nab-TC group was better compared to TC group (45% vs 40%), but the difference was not significant (P = 0.651). While the reduction rate of CA-125 value in the Nab-TC group was significantly better (P < 0.05). The postoperative complication rate such as postoperative blood transfusion (5% vs 35%) and postoperative infusion of human albumin (25% vs 55%) were significantly lower relative to the TC group. The median progression-free survival of the Nab-TC group was significantly longer relative to the TC group (20 months vs 13 months, P = 0.012), and the patient's quality of life was also better in the Nab-TC group (P < 0.05). Our study demonstrated that Nab-TC regimen and R0 represented the independent prognostic factors.

Conclusion: The efficacy of the Nab-TC regimen as NAC for advanced primary epithelial ovarian cancer was non-inferior to that of the TC regimen along with a lower incidence of adverse reactions, a longer PFS and a higher quality of life, supporting its therapeutic value in the clinic.

Keywords: Albumin-bound paclitaxel combined with carboplatin; Efficacy evaluation; Epithelial ovarian cancer; Neoadjuvant chemotherapy.

Conflict of interest statement

The authors have no competing interests to declare.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Survival outcomes between two groups

References

    1. Lecointre L, Velten M, Lodi M, et al. Impact of neoadjuvant chemotherapy cycles on survival of patients with advanced ovarian cancer: a French national multicenter study (FRANCOGYN) Eur J Obstet Gynecol Reprod Biol. 2020;245:64–72. doi: 10.1016/j.ejogrb.2019.12.001.
    1. Wright AA, Bohlke K, Armstrong DK, et al. Neoadjuvant chemotherapy for newly diagnosed, advanced ovarian cancer: Society of Gynecologic Oncology and American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. 2016;34(28):3460–3473. doi: 10.1200/JCO.2016.68.6907.
    1. Kehoe S, Hook J, Nankivell M, et al. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet. 2015;386(9990):249–257. doi: 10.1016/S0140-6736(14)62223-6.
    1. Elies A, Rivière S, Pouget N, et al. The role of neoadjuvant chemotherapy in ovarian cancer. Expert Rev Anticancer Ther. 2018;18(6):555–566. doi: 10.1080/14737140.2018.1458614.
    1. Fader AN, Rose PG. Abraxane for the treatment of gynecologic cancer patients with severe hypersensitivity reactions to paclitaxel. Int J Gynecol Cancer. 2009;19(7):1281–1283. doi: 10.1111/IGC.0b013e3181a38e2f.
    1. Gradishar WJ, Tjulandin S, Davidson N, et al. Phase III trial of nanoparticle albumin-bound paclitaxel compared with polyethylated castor oil-based paclitaxel in women with breast cancer. J Clin Oncol. 2005;23(31):7794–7803. doi: 10.1200/JCO.2005.04.937.
    1. Miele E, Spinelli GP, Miele E, et al. Albumin-bound formulation of paclitaxel (Abraxane ABI-007) in the treatment of breast cancer. Int J Nanomed. 2009;4:99–105.
    1. Coleman RL, Brady WE, McMeekin DS, et al. A phase II evaluation of nanoparticle, albumin-bound (nab) paclitaxel in the treatment of recurrent or persistent platinum-resistant ovarian, fallopian tube, or primary peritoneal cancer: a Gynecologic Oncology Group study. Gynecol Oncol. 2011;122(1):111–115. doi: 10.1016/j.ygyno.2011.03.036.
    1. Tillmanns TD, Lowe MP, Walker MS, Stepanski EJ, Schwartzberg LS. Phase II clinical trial of bevacizumab with albumin-bound paclitaxel in patients with recurrent, platinum-resistant primary epithelial ovarian or primary peritoneal carcinoma. Gynecol Oncol. 2013;128(2):221–228. doi: 10.1016/j.ygyno.2012.08.039.
    1. Tomao F, D'Incalci M, Biagioli E, et al. Restoring platinum sensitivity in recurrent ovarian cancer by extending the platinum-free interval: Myth or reality? Cancer. 2017;123(18):3450–3459. doi: 10.1002/cncr.30830.
    1. Untch M, Jackisch C, Schneeweiss A, et al. Nab-paclitaxel versus solvent-based paclitaxel in neoadjuvant chemotherapy for early breast cancer (GeparSepto—GBG 69): a randomised, phase 3 trial. Lancet Oncol. 2016;25:345–356. doi: 10.1016/S1470-2045(15)00542-2.
    1. Xie F, Chen R, Zhang L, et al. Efficacy of two-weekly nanoparticle albumin-bound paclitaxel as neoadjuvant chemotherapy for breast cancer. Nanomedicine (London) 2019;14(12):1595–1603. doi: 10.2217/nnm-2018-0485.
    1. Rodriguez N, Rauh-Hain JA, Shoni M, et al. Changes in serum CA-125 can predict optimal cytoreduction to no gross residual disease in patients with advanced stage ovarian cancer treated with neoadjuvant chemotherapy. Gynecol Oncol. 2012;125(2):362–366. doi: 10.1016/j.ygyno.2012.02.006.
    1. Winter WR, Maxwell GL, Tian C, et al. Prognostic factors for stage III epithelial ovarian cancer: a Gynecologic Oncology Group Study. J Clin Oncol. 2007;25(24):3621–3627. doi: 10.1200/JCO.2006.10.2517.
    1. Harter P, Sehouli J, Lorusso D, et al. A Randomized Trial of lymphade ectomy in patients with advanced ovarian neoplasms. N Engl J Med. 2019;380(9):822–832. doi: 10.1056/NEJMoa1808424.
    1. Colombo PE, Labaki M, Fabbro M, et al. Impact of neoadjuvant chemotherapy cycles prior to interval surgery in patients with advanced epithelial ovarian cancer. Gynecol Oncol. 2014;135(2):223–230. doi: 10.1016/j.ygyno.2014.09.002.
    1. Da CMV, de Souza FA, Dos AC, et al. Neoadjuvant chemotherapy with six cycles of carboplatin and paclitaxel in advanced ovarian cancer patients unsuitable for primary surgery: Safety and effectiveness. Gynecol Oncol. 2014;132(2):287–291. doi: 10.1016/j.ygyno.2013.12.002.
    1. Mahdi H, Maurer KA, Nutter B, Rose PG. The impact of percent reduction in CA-125 levels on prediction of the extent of interval cytoreduction and outcome in patients with advanced-stage cancer of Mulleria Norigin treated with neoadjuvant chemotherapy. Int J Gynecol Cancer. 2015;25(5):823–829. doi: 10.1097/IGC.0000000000000434.
    1. Desai N, Trieu V, Yao Z, et al. Increased antitumor activity, intratumor paclitaxel concentrations, and endothelial cell transport of cremophor-free, albumin-bound paclitaxel, ABI-007, compared with cremophor-based paclitaxel. Clin Cancer Res. 2006;12(4):1317–1324. doi: 10.1158/1078-0432.CCR-05-1634.
    1. Liao JB, Swensen RE, Ovenell KJ, et al. Phase II trial of albumin-bound paclitaxel and granulocyte macrophage colony-stimulating factor as an immune modulator in recurrent platinum resistant ovarian cancer. Gynecol Oncol. 2017;144(3):480–485. doi: 10.1016/j.ygyno.2017.01.008.
    1. Yamamoto Y, Kawano I, Iwase H. Nab-paclitaxel for the treatment of breast cancer: efficacy, safety, and approval. Onco Targets Ther. 2011;4:123–136. doi: 10.2147/OTT.S13836.
    1. Nabholtz JM, Gelmon K, Bontenbal M, et al. Multicenter, randomized comparative study of two doses of paclitaxel in patients with metastatic breast cancer. J Clin Oncol. 1996;14(6):1858–1867. doi: 10.1200/JCO.1996.14.6.1858.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する