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{TANDF_FPP}CMO/CMO_A_370883(NEW).3d (CMO) [First Proof]
Current Medical Research and OpinionC213 Volume 25, Number 3 2008
0300-7995 Article 4849/370883
doi:10.1185/03007990802707139 All rights reserved: reproduction in whole or part not permitted
Review
Current role and future aspects of topotecan in
relapsed ovarian cancer
Jalid Sehouli
ABSTRACT
Gu¨lten Oskay-O
¨
zcelik
,
European Competence Center for Ovarian Cancer,
Background:
Department of Gynecology and Obstetrics, Charite´
Ovarian cancer is the fifth leading cause of cancer deaths in women. It is associated with a poor prognosis,
University Hospital, Campus Virchow-Clinic, Berlin,
as the majority of patients present with advanced disease and relapse after radical surgery, and following
Germany
chemotherapy with carboplatin and paclitaxel.
Address for correspondence:
Objective:
Jalid Sehouli, European Competence Center for
To review the role of topotecan in the treatment of advanced and relapsed ovarian cancer, and the efficacy
Ovarian Cancer, Department of Gynecology and
and safety of novel dosing regimens and formulations of topotecan. It will also discuss further options of
Obstetrics, Charite´ University Hospital, Campus combination of topotecan with other cytotoxic agents and targeted therapies.
Virchow-Clinic, Berlin, Germany.
ed users can download
Tel.: þ49 30 450 564 052;
Research design and methods:
Fax: þ49 30 450 564 952;
The authors searched for relevant references in the MEDLINE database and in congress abstracts of the
sehouli@aol.com
American Society of Clinical Oncology.
thoris
le copy for personal use
Key words:
Results:
Chemotherapy – Ovarian cancer – Topotecan –
Topotecan is an established second-line therapy for advanced and relapsed ovarian cancer; a regimen of
Weekly
1.5 mg/m
2
/day 1–5 has been
n
t a sing
approved in the USA and many other western countries. Topotecan is well
Accepted: 22 December 2008; published online: 222 tolerated; associated haematological toxicity is generally manageable, reversible and non-cumulative.
A number of alternative dosing regimens and formulations have been investigated in an attempt to
improve the toxicity profile of topotecan without compromising anti-tumour activity. A novel oral
Copyright © 2009 Informa UK Limited
formulation of topotecan has shown clinical promise in patients with advanced and relapsed disease.
Administration of i.v. topotecan on a weekly basis produced encouraging results in several phase II
trials, with less haematological toxicity and similar response rates to the day 1–5 regimen. Also, recent
Not for Sale or Commercial Distribution
early studies demonstrate that topotecan is effective in combination with several other therapeutic agents in
the relapsed setting.
Unauthorized use prohibited. Au
display, view and pri
Conclusion:
The peer-reviewed literature reports that topotecan is an effective, well tolerated treatment option for
relapsed ovarian cancer.
Introduction
Ovarian cancer is the fifth leading cause of cancer death in women
1
. In the EU
in 2006,there were an estimated 40 600 new cases of ovarian cancer, and 28500
deaths related to ovarian cancer
2
. Ovarian cancer is associated with a poor
prognosis, owing to the fact that the disease is generally asymptomatic until
the tumour has progressed to an advanced stage
3
. There are currently no effec-
tivescreening toolsavailable forovariancancer.Additionally,initialsymptoms,
such as abdominal fullness and early satiety and bloating, are non-specific and
subtle, making early diagnosis extremely difficult
3,4
. Survival is highly
!
2009 Informa UK Ltd
www.cmrojournal.com Topotecan for relapsed ovarian cancer Sehouli & Oskay-O
¨
zcelik
1
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