Women with recurrent, multiply treated epithelial ovarian cancer (EOC) have unfavorable prognosis with limited treatment options after failure of platinum based regimens. Antiangiogenic therapies have shown some efficacy in these patients. We report here a retrospective analysis of women with recurrent, platinum resistant EOC treated with an oral regimen of anti-angiogenic agent Pazopanib and Cyclophosphamide.
Women with histologically proven recurrent platinum-resistant EOC were treated with tablets pazopanib (600mg p.o. daily in two divided doses, 400 mg and 200 mg) and cyclophosphamide (50 mg p.o. daily for 14 days every 21 days) until disease progression or unacceptable toxicity. Response was evaluated radiologically every 12 weeks.
Eighteen patients (16 platinum resistant and 2 platinum refractory) were treated between April 2014 and April 2017 with a mean age of 50 (38-60) years and median 4 (2- 8) previous lines of chemotherapy, including three patients with progressive disease on bevacizumab. Patients received a median of 6 (2-28) cycles of pazopanib and cyclophosphamide with partial response in 8 (44%) patients (including 1 of 3 prior bevacizumab treated patients), stable disease in 5 (28%) and disease progression in 5 (28%) patients, as best response. The median progression-free survival was 5.0 months. Common adverse events were fatigue (50%), diarrhea (50%), elevated liver enzymes (43%), mucositis (61%), myelosuppression (28%), Skin toxicity (33%), hypertension (6%) and hair depigmentation (6%). Dose reduction due to toxicity was required in 11 (61%) patients and no patient stopped treatment due to toxicity.
Pazopanib and oral cyclophosphamide is a well-tolerated regimen with clinically relevant benefit in platinum resistant, epithelial ovarian cancer patients.
Clinical trial identification
This is a retrospective analysis of Platinum resistant epithelial ovarian cancer patients treated at our instittute. The approval for doing this analysis was taken from Insitute s ethics committee.
Legal entity responsible for the study
Institutional Review Board Institutional Review Board, Tata Memorial Hospital, Mumbai, India
All authors have declared no conflicts of interest.