Oxaliplatin Is a Safe Alternative Option for Patients With Recurrent Gynecologic Cancers After Hypersensitivity Reaction to Carboplatin. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Kolomeyevskaya, Nonna V.; Lele, Shashikant B.; Miller, Austin; Riebandt, Grazyna C.; Blum, Bonnie L.; Odunsi, Kunle O.; Frederick, Peter J.
• Is Part Of: International journal of gynecological cancer. Volume 25:Issue 1(2015:Jan.)
• Publication Date: 2015-01
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0000000000000307
• Languages: English
• ISSNs: 1048-891X

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objective</title> <p>The aim of this study was to determine the tolerability and efficacy of oxaliplatin in patients with recurrent gynecologic malignancies after carboplatin hypersensitivity reactions in comparison with conventionally used cisplatin.</p> </sec> <sec> <title>Methods</title> <p>Forty-six patients were treated with platinum-based chemotherapy from 2006 to 2011 and developed hypersensitivity reactions to carboplatin. Oxaliplatin was administered to 27 patients; 19 patients received cisplatin. Clinicopathologic variables, toxicity, and time-to-failure were analyzed retrospectively using descriptive statistics, Fisher exact, and independent sample permutation <italic>t</italic> tests.</p> </sec> <sec> <title>Results</title> <p>The median number of carboplatin cycles and cumulative dose before reaction were similar in the oxaliplatin and cisplatin groups, respectively (6 vs 7.5 cycles, <italic>P</italic> = 0.93; 980 [662] mg vs 686 [579.6] mg, <italic>P</italic> = 0.49). Non–life-threatening hypersensitivity reaction to oxaliplatin developed in 2 of 27 patients. No reactions to cisplatin occurred. The median number of oxaliplatin/cisplatin cycles was 6 in both groups. Complete response to therapy was 34.6% (oxaliplatin) and 31.6% (cisplatin); stable disease was seen in 50.0% and 36.8% of oxaliplatin- and cisplatin-treated patients, respectively (<italic>P</italic> = 0.46). Exposure to oxaliplatin resulted in less neurotoxicity than cisplatin (25.9% vs 68.4%, <italic>P</italic> = 0.01). The median number of prior chemotherapy lines in both groups was 2. The median time-to-failure was 10.8 months in oxaliplatin group and 9.8 months in cisplatin group (<italic>P</italic> = 0.86).</p> </sec> <sec> <title>Conclusions</title> <p>Salvage therapy with oxaliplatin after hypersensitivity reaction to carboplatin is associated with excellent tolerability and time-to-failure comparable to cisplatin. When further administration of carboplatin is precluded, oxaliplatin represents a safe and effective treatment strategy in the platinum-sensitive relapse setting. The significantly lower neurotoxicity profile makes it an attractive alternative to cisplatin.</p> </sec> </abstract>