Feasibility study of oral cyclophosphamide salvage therapy for the treatment of heavily pretreated patients with recurrent epithelial ovarian cancer

In patients with relapsed ovarian cancer, the objectives of salvage therapy are considered to be maintenance of quality of life and prolongation of patient survival. Chemotherapy using oral agents could be a good choice for salvage therapy. We reassessed the usefulness of oral cyclophosphamide (CPA) salvage therapy for heavily pretreated patients with recurrent epithelial ovarian cancer. We evaluated the effects and toxicities of 100 mg oral dose (50 mg twice a day) of CPA for 14 patients who had undergone an average of 3 chemotherapy treatments before enrolling in our study. One patient showed partial response and 8 developed stable diseases. Median time to progression was 3 months (range 1-13 months) and median survival was 7 months (range 2-28 months). Common Terminology Criteria for Adverse Events (CTCAE) grade 3/4 adverse effects were leukopenia (7.1%), neutropenia (14.3%), thrombocytopenia (7.1%), and nausea/vomiting (21.4%). Although moderate gastrointestinal toxicity was observed, oral CPA therapy contributed to improving the survival of heavily pretreated patients with recurrent epithelial ovarian cancer. A well-designed phase II trial in this regard is awaited.