903P - Effectiveness and toxicity of vinblastine, cisplatin, cyclophosphamide, bleomycin, doxorubicin and etoposide (VPCBAE) in the management of patients...

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Ovarian Cancer
Presenter Donato Callegaro-Filho
Citation Annals of Oncology (2014) 25 (suppl_4): iv305-iv326. 10.1093/annonc/mdu338
Authors D. Callegaro-Filho1, P.T. Ramirez2, A.M. Nick2, J.J. Kavanagh3, E.D. Euscher4, A.S. Dickens5, D.K. Patel5, K.M. Schmeler2
  • 1Oncology, Hospital Israelita Albert Einstein, 05652-000 - Sao Paulo/BR
  • 2Gynecology Oncology, MD Anderson Cancer Center, Houston/US
  • 3International Oncology Program, Chulalongkorn University, Bangkok/TH
  • 4Pathology, MD Anderson Cancer Center, Houston/US
  • 5Clinical Pharmacology, MD Anderson Cancer Center, Houston/US

Abstract

Aim

Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a rare and aggressive malignant tumor with a poor prognosis. There is no consensus on the optimal treatment but it is hypothesized that multi-agent chemotherapy may extend survival.

Methods

We performed a retrospective study of all patients evaluated at MD Anderson Cancer Center (MDACC) between May 2004 and April 2014 with the diagnosis of SCCOHT and identified 8 patients treated with vinblastine (6 mg/m2 on Day 1), cisplatin (90 mg/m2 on Day 1), cyclophosphamide (1000 mg/m2 on Day 2), bleomycin (15 units/m2 on Day 2), doxorubicin (45 mg/m2 IV on Day 3) and etoposide (200 mg/m2 on Day 3) (VPCBAE) followed by pegfilgrastim (6 mg) as primary treatment following surgery.

Results

The median age at diagnosis was 28 years (range, 21-41). Five patients had stage I disease (63%), 2 had stage III disease (25%) and 1 had stage IV disease (12%). Seven patients (88%) underwent unilateral salpingo-oophorectomy due to a desire for fertility preservation. Five patients (63%) had an optimal tumor reduction with no visible residual disease, all stage I disease. All patients completed 6 chemotherapy cycles, and 7 (88%) had no evidence of disease after chemotherapy. Two patients (25%) died of disease and 2 patients (25%) are alive with disease. 4 patients (50%), all stage I disease, are alive without evidence of disease with a median follow up of 37.5 months (range, 5-60 months). Grade 3 to 4 toxicities included anemia (83%), neutropenia (67%), febrile neutropenia (33%), thrombocytopenia (67%) and nausea (17%). There were 6 hospitalizations, 5 treatment delays, 1 dose reduction, and a drug discontinuation (bleomycin due to grade 2 pulmonary fibrosis). Red cell and/or platelet transfusions were administered in 5 patients (83%). There were no treatment related deaths.

Conclusions

VPCBAE combination is effective in patients with SCCOHT and associated toxicities are tolerable.

Disclosure

All authors have declared no conflicts of interest.