The Efficacy And Safety Of Pemetrexed-Platinum Combination In Patients With Recurrent Epithelial Ovarian Cancer

Objectives:The main purpose of this study was to evaluate the efficacy and tolerability of Pemetrexed-Platinum combination on recurrent epithelial ovarian cancer by gathering and analyzing application situation. Hopefully this study would provide evidence for clinical choice of second-line chemotherapy.Methods:A single centered retrospective study comprising of 22 recurrent EOC patients was conducted, and all 22 patients were treated with Pemetrexed 500 mg/m2 on day 1 along with Cisplatinum75mg/m2, Carboplatin AUC5, Nedaplatin 80 mg/m2, Lobaplatin 30mg/m2 respectively on day 1 after Pemetrexed of 3 weeks treatment cycle. Patients were pretreated with folic acid, Vitamin B12 and dexamethasone, they also got standard antiemetics during therapy. Patients were treated until disease progression or appearing severe toxicity cannot be corrected by routine therapies. The efficacy and toxicity were evaluated every two cycles according to RECIST1.1 and CTCAE 4.0. The primary endpoints were objective response rate, disease control rate, progression-free survival and toxicity. The connection between efficacy and factors were judged by Fisher’s exact test, P<0.05 was considered statistically significant. Cox multivariate analysis method was performed for PFS analysis, P<0.05 was considered statistically significant.Results:1. There were 22 patients with recurrent epithelial ovarian cancer receiving Pemetrexed-Platinum combination regimen according the inclusion and exclusion criteria.2. Efficacy:the objective response rate was 31.8% while the disease control rate was 63.4%, the median progression-free survival was 5.4months [95%CI (4.7,6.1)].3. Factors analysis:Fisher’s exact test showed that age, pathological type, FIGO staging, chemotherapy regimen, secondary cytoreductive surgery and recurrent type did not make any difference to ORR and DCR. By Cox multivariate analysis, pathological type, FIGO staging and secondary cytoreductive surgery could influence the PFS.4. Toxicity:mainly included anemia(45.5%), leukopenia(36.3%), neutropenia(36.3%), constipation(31.8%), nausea/emesis(27.3%), fatigue(22.8%) and so on. No Grade IV toxicity was observed, most of toxicity were mild and tolarated. Three patients had G3 hematologic toxicity, and got better after getting treated by G-CSF and rhIL-11, no patients quitted because of toxicity. One patient had G2 nausea/emesis, and 1 patient had G2 constipation while other digestive adverse reactions were limited to Gl. Besides, a few patients had nephrotoxicity, hepatotoxicity, neurotoxicity and hair loss.Conclusion:The efficacy of Pemetrexed-Platinum combination on recurrent epithelial ovarian cancer was exact, and patients could tolerate. Pathological type, FIGO staging and secondary cytoreductive surgery could influence the PFS.