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 Anticancer agents
Ovarian Cancer
Therapy
Biological therapy
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.