Intraperitoneal cisplatin-mitoxantrone and intravenous ifosfamide combination as first-line treatment of ovarian cancer

Abstract

Twenty-one chemotherapy naive ovarian cancer patients with stage III and minimal residual tumor were treated with cisplatin 75 mg/m(2) and mitoxantrone 15 mg/m(2) (1st day) by intraperitoneal (IP) route and ifosfamide 4 g/m(2) (15th day) by IV route every 4 weeks for a total of 6 cycles. Pathologic complete response (pCR) was achieved in 9/20 (45%, 95% Confidence Interval - CI - 23-68) of the patients. The median progression free interval (PFI) of the patients with pCR was 45 (range: 18-70) months. For patients with residual tumor <1cm (n: 11); pCR was 82% and could be achieved only in this subgroup of patients. The cumulative (PFI) and overall survival rate of all patients at 3 years were 40% and 52%, respectively. The median PFI was found to be significantly different between the patients with residual tumor <1cm (48 months, 95% CI 42-54) and 1-2 cm (9 months, 95% CI 1-16) p<0.001. Main toxicities were emesis and abdominal pain which occurred in 53% and 65% of the courses, respectively. This combination seems to be an effective and feasible approach to previously untreated ovarian cancer patients with minimal tumor burden.