PURPOSE: To evaluate the efficacy of carboplatin plus paclitaxel in primarily advanced or recurrent endometrial cancers. PATIENTS AND METHODS: Four distinct patient groups received carboplatin (area under the curve, 5 to 7) plus paclitaxel 175 mg/m2 for 3 hours at 4-week intervals: group 1 (n = 21), patients with primarily advanced, nonpapillary serous cancers; group 2 (n = 20), the same as group 1 but with papillary serous cancers; group 3 (n = 18), recurrent, nonpapillary serous cancers; and group 4 (n = 4), recurrent, papillary serous cancers. Involved-field irradiation was used in groups 1 and 2 for those with radioencompassable disease. RESULTS: Sixty-three patients were treated. Response rates to chemotherapy in the assessable patients in the four groups were 78% (95% confidence interval [CI], 51% to 100%); 60% (95% CI, 35% to 85%), 56% (95% CI, 34% to 78%), and 50%, respectively. Nineteen patients (90%) in group 1 also were irradiated, and the median failure-free survival time for all 21 patients w...

Paclitaxel and Carboplatin, Alone or With Irradiation, in Advanced or Recurrent Endometrial Cancer: A Phase II Study

https://rihuc.huc.min-saude.pt/bitstream/10400.4/126/1/Ann%20Oncol%20441.pdf

Doxorubicin versus doxorubicin and cisplatin in endometrial carcinoma: definitive results of a randomised study (55872) by the EORTC Gynaecological Cancer Group

Chemotherapy for advanced, recurrent or metastatic endometrial cancer: a systematic review of Cochrane collaboration

Background Although endometrial adenocarcinoma is a common gynaecological cancer, a comparatively small proportion of patients present with, or develop, recurrent or advanced disease. However, for those women whose disease does progress or recur the prognosis is poor and the best treatment is yet to be identified. Co-morbidity, including obesity and cardiac disease, and concerns over toxicity have prevented more extensive studies of cytotoxic chemotherapy, although there are a number of active agents. Objectives To assess any benefits or adverse effects of cytotoxic chemotherapy in women with advanced, recurrent or metastatic endometrial adenocarcinoma. Search methods Systematic searches of MEDLINE, EMBASE, CENTRAL and the Cochrane Gynaecological Cancer specialist trials register were conducted to identify all eligible randomised controlled trials (RCTs).Databases were searched from 1966 to January 2012. Literature searches were supplemented with searches of relevant trials registers and conference proceedings. Selection criteria RCTs comparing chemotherapy versus another intervention (including different chemotherapy) in advanced disease were considered. Trials of adjuvant treatment or for sarcomatous tumours were excluded. Data collection and analysis Data were extracted from the papers by review authors and authors of included studies contacted for further information. Main results Fourteen eligible trials, which recruited patients between 1974 and 2005, were identified, eight of which compared 'more' with 'less' chemotherapy. Results from these eight trials, including 1519 patients, showed that treatment consisting of 'more' chemotherapy was associated with longer overall survival (OS) (hazard ratio (HR) 0.86; 95% confidence intervals (CI) 0.77 to 0.96; P = 0.005) and with longer progression-free survival (PFS) (n = 1526; HR 0.82; 95% CI 0.74 to 0.90; P Authors' conclusions This review suggests that more-intense chemotherapy regimens may improve both OS and PFS for women with advanced or recurrent endometrial cancer. However, owing to inconsistencies between cytotoxic drug combinations that have been assessed in randomised trials to date, the optimum regimen has still to be defined. Future trials should aim to include measures of quality of life (QoL) and symptom control in addition to survival and progression outcomes.

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Chemotherapy for advanced, recurrent or metastatic endometrial carcinoma

Renewed interest in vancomycin over the past decade has led to an abundance of data concerning the pharmacokinetics of vancomycin, and its dosage selection and concentration-response relationships.

Pharmacokinetic optimisation of vancomycin therapy.

Sixteen patients with advanced (International Federation of Gynecology and Obstetrics stage III and IV) adenocarcinoma of the endometrium were treated with twelve 28-day cycles of doxorubicin and cisplatin. Response was achieved in 92% of patients (11 responses among 12 patients) who had received no prior chemotherapy and in 50% (two responses among four patients) of previously treated patients. Median survival was 10 months. Doxorubicin and cisplatin were readily administered on an outpatient basis with comparatively low major toxic effects, primarily hematologic, renal, and gastrointestinal. These results indicate that doxorubicin and cisplatin combination therapy is effective with acceptable toxicity in patients with advanced endometrial carcinoma.

Treatment of advanced endometrial carcinoma with doxorubicin and cisplatin: effects on both untreated and previously treated patients.

Many chemotherapeutic agents are nephrotoxic and/or excreted via the kidney. Thus, careful evaluation of renal function is important since drug dosages are often lowered in patients with impaired renal function. When the creatinine clearance as calculated by the method of Cockcroft and Gault from the patient's age, weight, and serum creatinine was compared to the measured creatinine clearance in the same patients, the correlation coefficient was low (r = 0.40) and the average difference between the predicted and measured creatinine clearance values was 25.3%. Thus, in our patient population, creatinine clearance calculated by the method of Cockcroft and Gault did not correlate well with measured creatinine clearance and thus was not useful as a clinical tool.

Galindo A

Papers

Treatment of advanced endometrial carcinoma with doxorubicin and cisplatin: effects on both untreated and previously treated patients.

Inadequacy of predicted creatinine clearance as guide to chemotherapy.