1004P - Case control study on two different chemotherapy regimens in advanced mixed mullerian tumours

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Anti-Cancer Agents & Biologic Therapy
Gynaecologic Malignancies
Presenter Maria Mancini
Authors M. Mancini1, S. Ramondino2, R. Di Rocco2, M. Ratti2, D. Lorusso1, F. Raspagliesi3
  • 1Gynecology Oncology, Fondazione IRCCS National Cancer Institute of Milan, 20133 - Milan/IT
  • 2Gynecology Oncology, Fondazione IRCCS National Cancer Institute of Milan, Milan/IT
  • 3Department Of Gynaecologic Oncology, National Cnacer Institute of Milan, 20133 - Milan/IT

Abstract

Background

Malignant mixed Mullerian tumours (MMMTs) of the uterus and adnexa represent aggressive gynaecologic malignancies with a high rate of loco-regional and distant failure. There is no consensus in the community about the preferred chemotherapy regimen in this population. We evaluated two different chemotherapy combinations in terms of toxicity and oncologic outcome in patients with advanced MMMTs.

Methods

Female patients with advanced MMMTs, residual tumor < 1 cm at cytoreductive surgery, no prior chemotherapy, normal haemopoietic and organ function were eligible. Chemotherapy was administered according to two different regimens: Cisplatin 20 mg/mq- Ifosfamide 1500 mg/mq d 1-4 q 21+ Pegfilgrastim (Group A) and Carboplatin AUC 5-Paclitaxel at 175 mg/m2 day 1 q21 (Group B).

Results

Twenty-four patients (pts) of a median age 64 (49-75) years, performance status <2 with advanced MMMTs of the uterus (n = 11) or ovary (n = 13) were enrolled. FIGO stage in group A (10 patients) was: stage II: 2 pts; III: 6 pts; IV: 2 pts. FIGO stage in arm B was: stage II: 3 pts; III: 7 pts; IV: 4 pts. Most patients were Grade 3 (60% and 64% in arm A and B, respectively). Median progression-free survival was 15.2 (range 3.1-33.1) months and 14.3 (range 3.7-27.9) months (p= ns) for group A and B, respectively. Median OS was 16.4 (range 3.2-52.8) and 16.4 (range 5.3-35.1) months for arm A and B, respectively (p = ns). Grade 3/4 neutropenia was recorded in 25% of group B pts while no pts in group A experienced it due to the prophylactic use of pegfilgrastim. In contrast, 10% of pts in group A reported grade 3-4 anemia requiring blood transfusions while no pts in group B registered the same toxicity. Grade 3-4 thrombocytopenia was registered in 7% of arm A pts. For non-haematologic toxicities, grade 2 neurotoxicity was reported by 28% of patients in group B while 10% of pts in group A experienced grade 2 asthenia.

Conclusion

The two treatments appear overlapping in terms of oncologic outcome but present different toxicity profiles which could suggest individualized treatment in terms of toxicity, cost of treatment and hospitalization (arm A) vs outpatient (arm B) treatment. The two regimens warrant further randomized comparison.

Disclosure

All authors have declared no conflicts of interest.