4.3 Article

Immunomodulatory therapy in refractory/recurrent ovarian cancer

期刊

出版社

ELSEVIER TAIWAN
DOI: 10.1016/j.tjog.2014.04.027

关键词

epithelial ovarian cancer; immunomodulatory therapy; recurrence

资金

  1. Chang Gung Medical Foundation (CMRPG) [3A0241, 3A0242, 370651, 370652, 370653]
  2. Department of Health, Taiwan [DOH100-TD-B-111-005, DOH101-TD-B-111-005]

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Objective: To investigate the efficacy and toxicity of immunomodulatory therapy (IMT) alone or as an add-on to palliative/salvage chemotherapy in patients with refractory/recurrent epithelial ovarian cancer (EOC). Materials and methods: We retrospectively analyzed the efficacy and toxicity of IMT in 15 patients with refractory/recurrent EOC who had previously received multiple chemotherapy regimens. Results: The median age of the patients was 56 years (range, 41-75 years). Three patients were platinum-sensitive, two were platinum-resistant, and the remaining 10 patients were refractory to platinum-based front-line chemotherapy. IMT consisted of picibanil (OK-432) on Day 1, interleukin-2 and/or interferon-alpha on Day 2 administered by subcutaneous injection (every week or 2-weekly). Five patients never received metronomic oral cyclophosphamide. After IMT, three patients achieved partial remission (PR, lasting for 11 months, >= 12 months, and 16 months), and six patients had stable disease (SD). The disease stabilizing, rate (PR+SD) was 60% (3/3 in platinum-sensitive and 6/12 in platinum-resistant/refractory patients). The absolute lymphocyte count (ALC) at 1 month after IMT was significantly higher in the PR+SD group (median 1242.0/mu L) than in the progression group (median 325.0/mu L) (p = 0.012). No >= Grade 3 toxicities were observed. The median post-IMT survival time was 12 months (range, 2-39 months). Conclusion: IMT alone or add-on to palliative/salvage chemotherapy for refractory/recurrent EOC achieves a substantial disease stabilizing rate without severe toxicity, which might be a potential option in selected patients. The ALC 1 month after IMT could be an early indicator to disease stabilization. Copyright (C) 2015, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC. All rights reserved.

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