LANCET ONCOLOGY
Trabectedin too toxic in ovarian cancer
Sally Simpson
Available online 3 December 2007.
Trabectedin shows modest activity but substantial toxic effects in the treatment of ovarian cancer (Br J Cancer, published online Nov 13, 2007; DOI:10.1038/sj.bjc.6604088).
Carolyn Krasner (Massachusetts General Hospital, Boston, MA, USA) and colleagues did a phase II study on 147 patients with ovarian cancer, who had all previously had platinum-containing chemotherapy. 66 patients sensitive to platinum chemotherapy and 81 patients resistant to platinum chemotherapy were given trabectedin via a central venous catheter once weekly for three weeks on a 28 day cycle.
141 patients were assessable by use of Response Evaluation Criteria in Solid Tumors (RECIST) after treatment. Four patients had a complete response, but all four were patients who were sensitive to platinum-contain chemotherapy. In the rest of the platinum-sensitive group, 14 patients had a partial response, 22 had stable disease, and 22 had progressive disease. In the platinum resistant group, five patients had a partial response, 36 had stable disease, and 38 had progressive disease.
146 of 147 patients reported toxic effects, the most common of which were granulocytopenia, nausea, vomiting, and fatigue. Five patients died during treatment or within 30 days of the last dose.
Krasner says “trabectedin is an active agent in the treatment of ovarian cancer and will add to the armementarium used to treat this deadly disease”.
Maurie Markman (MD Anderson Cancer Center, Houston, TX, USA) is concerned by the toxic effects noted in the study. He adds, “this phase II trial has revealed trabectedin to be an active agent in ovarian cancer. However, defining a possible role for this drug will require future investigative efforts, especially considering the fact several other agents have demonstrated similar levels of activity in this clinical setting”.