Trabectedin as single agent in the salvage treatment of heavily treated ovarian cancer patients: a retrospective, multicenter study

Gynecol Oncol. 2013 Sep;130(3):505-10. doi: 10.1016/j.ygyno.2013.06.008. Epub 2013 Jun 14.

Abstract

Objective: The aim of this multicenter, retrospective study was to evaluate the efficacy and the safety of single agent Trabectedin (ET-743, Yondelis) in very heavily treated, relapsed ovarian cancer (ROC) patients.

Patients and methods: Response to treatment was classified according to RECIST criteria. Progression-free (PFS), and overall survival (OS) were also assessed.

Results: 98 patients were analyzed (originally 67 platinum sensitive, and 31 platinum refractory/resistant). Median number of previous regimens was 4 (range: 1-6). In the whole population, overall response rate (ORR) was 27.5%; stable disease (SD) was observed in 33 patients (33.6%), and clinical benefit was achieved in 60 cases (61.2%). ORR was 38.6% in fully platinum sensitive population, and 26.1% in partially platinum sensitive patients. In platinum refractory/resistant disease, ORR was 12.9%. Overall, median PFS and OS were 5, and 13 months, respectively. Patients responding to Trabectedin showed a more favorable PFS (median = 9 months) than patients with SD (median = 6 months), or progression (median = 2 months). Median OS of responding patients was 18 months compared to 14 months in SD patients, and 9 months in progressing patients. Grade 3-4 neutropenia was observed in 17 (17.3%) patients. Transient and non-cumulative Grade 3-4 AST and ALT level elevation was found in 7 (7.1%), and 13 (13.3%) cases, respectively. There was 1 case of Grade 3, and 1 case of Grade 4 cardiac toxicity.

Conclusions: Trabectedin, as a single agent, retains its efficacy in terms of rate of ORR and clinical benefit in heavily treated ROC patients, especially in the group of platinum sensitive disease.

Keywords: Ovarian cancer; Salvage treatment; Trabectedin.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Alanine Transaminase / blood
  • Antineoplastic Agents, Alkylating / adverse effects
  • Antineoplastic Agents, Alkylating / therapeutic use*
  • Aspartate Aminotransferases / blood
  • Asthenia / chemically induced
  • Carcinoma / therapy*
  • Dioxoles / adverse effects
  • Dioxoles / therapeutic use*
  • Disease-Free Survival
  • Drug Resistance, Neoplasm
  • Female
  • Humans
  • Middle Aged
  • Neutropenia / chemically induced
  • Ovarian Neoplasms / therapy*
  • Platinum Compounds
  • Retrospective Studies
  • Salvage Therapy*
  • Tetrahydroisoquinolines / adverse effects
  • Tetrahydroisoquinolines / therapeutic use*
  • Trabectedin

Substances

  • Antineoplastic Agents, Alkylating
  • Dioxoles
  • Platinum Compounds
  • Tetrahydroisoquinolines
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Trabectedin