Abstracts
Ovarian Cancer | Small Cell Lung Cancer | Cervical Cancer

Ovarian Cancer


Hematologic safety and tolerability of topotecan in recurrent ovarian cancer and small cell lung cancer: an integrated analysis.
Armstrong DK, Spriggs D, Levin J, Poulin R, Lane S. Oncologist. 2005;10(9):686-694.

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Topotecan versus paclitaxel for the treatment of recurrent epithelial ovarian cancer.
ten Bokkel Huinink W, Gore M, Carmichael J, et al. J Clin Oncol. 1997;15(6):2183-2193.

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Topotecan has substantial antitumor activity as first-line salvage therapy in platinum-sensitive epithelial ovarian carcinoma: a Gynecologic Oncology Group study.
McGuire WP, Blessing JA, Bookman MA, Lentz SS, Dunton CJ. J Clin Oncol. 2000;18(5):1062-1067.

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Clinical evidence for topotecan-paclitaxel non–cross-resistance in ovarian cancer.
Gore M, ten Bokkel Huinink W, Carmichael J, et al. J Clin Oncol. 2001;19:1893-1900.

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Randomized phase II study of two schedules of topotecan in previously treated patients with ovarian cancer: a National Cancer Institute of Canada Clinical Trials Group study.
Hoskins P, Eisenhauer E, Beare S, et al. J Clin Oncol. 1998;16:2233-2237.

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Small Cell Lung Cancer


Hematologic safety and tolerability of topotecan in recurrent ovarian cancer and small cell lung cancer: an integrated analysis.
Armstrong DK, Spriggs D, Levin J, Poulin R, Lane S. Oncologist. 2005;10(9):686-694.

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Topotecan versus cyclophosphamide, doxorubicin, and vincristine for the treatment of recurrent small-cell lung cancer.
von Pawel J, Schiller JH, Shepherd FA, et al. J Clin Oncol. 1999;17:658-667.

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Topotecan in the treatment of relapsed small cell lung cancer patients with poor performance status.
Treat J, Huang CH, Lane SR, Levin J. Oncologist. 2004;9:173-181.

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Topotecan in the treatment of elderly patients with relapsed small-cell lung cancer.
Garst J, Buller R, Lane S, Crawford J. Clin Lung Cancer. 2005;7(3):190-196.

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Cervical Cancer


Randomized phase III trial of cisplatin with or without topotecan in carcinoma of the uterine cervix: a Gynecologic Oncology Group study.
Long HJ III, Bundy BN, Grendys EC Jr, et al. J Clin Oncol. 2005;23:4626-4633.

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Important Safety Information

Contraindications

Hycamtin is contraindicated in patients who have a history of hypersensitivity reactions to topotecan or to any of its ingredients. Hycamtin should not be used in patients who are pregnant or breast-feeding, or those with severe bone marrow depression.

Warnings

Hycamtin should be used only in patients with adequate bone marrow reserves, including baseline neutrophil counts of at least 1,500 cells/mm3 and platelet counts of at least 100,000/mm3. Frequent monitoring of blood counts should be instituted during treatment with Hycamtin.

Patients should not be treated with subsequent courses of Hycamtin until neutrophils recover to >1,000 cells/mm3, platelets recover to >100,000 cells/mm3, and hemoglobin levels recover to 9.0 g/dL (with transfusion if necessary).

Hycamtin may cause fetal harm when administered to a pregnant woman. Women of childbearing potential should be advised to avoid becoming pregnant during therapy with Hycamtin.

Drug Interactions

Concomitant administration of G-CSF can prolong the duration of neutropenia, so if G-CSF is to be used, it should not be initiated until day 6 of the course of therapy, 24 hours after completion of treatment with Hycamtin.

Myelosuppression was more severe when Hycamtin was given in combination with cisplatin in phase I studies. In a reported study on concomitant administration of cisplatin 50 mg/m² and Hycamtin at a dose of 1.25 mg/m²/day x 5 days, 1 of 3 patients had severe neutropenia for 12 days, and a second patient died with neutropenic sepsis. There are no adequate data to define a safe and effective regimen for Hycamtin and cisplatin in combination.

Adverse Events

Frequently reported nonhematologic adverse events associated with use of Hycamtin included nausea (64%), vomiting (45%), diarrhea (32%), alopecia (49%), fatigue (29%), and dyspnea (22%). Most nonhematologic toxicities were grade 1 or 2.


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