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 The treatment of ovarian cancer is rapidly evolving. Current treatment of ovarian cancer depends on a number of factors, including the stage of the disease and the general health of the patient. Unfortunately, due to lack of effective detection tools and the fact that many women are asymptomatic, many will present with advanced-stage disease. 
Therapy for advanced-stage ovarian cancer involves a number of surgical techniques. Typically, these surgical procedures include
Surgery is followed by platinum-based chemotherapy, and increasingly carboplatin, with or without a taxane, is used rather than cisplatin, since it has less toxicity and equivalent activity. [18] Though the initial response rates are 70% to 80%, which includes a good portion of complete responses, the majority of women will eventually relapse. [2] Treatment of recurrent ovarian cancerThe interval between the completion of initial therapy and the relapse is key to determining appropriate therapy options. The disease relapse is typically broken into two groups:
Patients with platinum-sensitive disease who have had a significant response to cisplatin or carboplatin may again respond to treatment with one of these agents. Patients are typically either treated with the same drug or are alternated between cisplatin and carboplatin. [18] The likelihood that the patient will respond increases as the length of time since the patient was last treated increases. [24] Other agents used in patients with platinum-resistant/refractory disease may also be considered. In patients with platinum-resistant/refractory disease whose disease progressed while on a platinum regimen or recurred shortly after regimen completion, there are a number of second-line agents available, including
Several studies have compared the various single agents as well as whether the use of combination therapy is superior to single agents. In addition, randomized trials have been performed to compare the different agents. For more information, please visit the following sections on this site:
Or visit, the National Cancer Institute’s Web site for more treatment information. DisclaimerThese sites are not part of Hycamtin.com, a GlaxoSmithKline Web site. The content and materials in these third-party Web sites are not produced or endorsed by GlaxoSmithKline.Some of these third-party Web sites may refer to uses of our products that are not recommended by GlaxoSmithKline. You should always consult with your physician or health care professional before using any GlaxoSmithKline prescription product. Important Safety InformationIndicationsHycamtin is indicated for the treatment of metastatic carcinoma of the ovary after failure of initial or subsequent chemotherapy.ContraindicationsHycamtin 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.WarningsHycamtin 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). Severe myelotoxicity has been reported when 5-day dosing of Hycamtin is used in combination with cisplatin. 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 InteractionsConcomitant administration of G-CSF can prolong the duration of neutropenia, so if G-CSF is to be used, it should not be initiated until 24 hours after completion of treatment with Hycamtin.Myelosuppression was more severe when Hycamtin, at a dose of 1.25 mg/m²/day x 5 days, was given in combination with cisplatin at a dose of 50 mg/m² in phase I studies. In one study, 1 of 3 patients had severe neutropenia for 12 days, and a second patient died with neutropenic sepsis. Adverse EventsThe most common serious adverse event is myelosuppression.Severe neutropenia, the dose-limiting toxicity for Hycamtin, occurred in 78% of 879 ovarian and small cell lung cancer patients treated. Other hematologic adverse events reported include severe leukopenia (32%), severe thrombocytopenia (27%), and severe anemia (37%). 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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