Paclitaxel, carboplatin, and hexamethylmelamine (Taxchex) as first-line therapy for ovarian cancer

Ellen M. Hartenbach, L. S. Harris, H. H. Bailey, E. A. Grosen, E. Larrison, D. Chen, L. B. Twiggs, J. C. Schink

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND. The addition of hexamethylmelamine to therapy with cisplatin, cyclophosphamide, and doxorubicin significantly enhanced outcomes of patients with advanced ovarian cancer. Hexamethylmelamine, also known as altretamine, has potent antineoplastic activity when used as a single agent in patients who have failed to respond to both platinum-based and paclitaxel therapy. We have conducted a pilot study to evaluate the efficacy and safety of adding this drug to the popular ovarian cancer regimen of paclitaxel plus carboplatin. METHODS. Patients with advanced ovarian, fallopian tube, or primary peritoneal cancer (International Federation of Gynecology and Obstetrics stages IIA, IIIC, and IV) were prospectively enrolled to receive six cycles, repeated every 4 weeks, of paclitaxel (150 mg/m2 IV, day 1), carboplatin (AUC 5.0 IV, day 1), and hexamethylmelamine (150 mg/m2 PO, days 2-15). Colony stimulating factors were prohibited. Response and toxicity were monitored by use of Eastern Cooperative Oncology Group criteria. RESULTS. Twenty patients were enrolled, 18 with ovarian cancer, one with fallopian tube cancer, and one with peritoneal cancer; 17 of these patients were evaluable for response and toxicity. At a median follow-up of 6.5 months, 13 of the patients had a complete response (76%), and four had progressive disease. Three of those with a complete response had a recurrence within 1 year of completing treatment. Toxicity was acceptable, with myelosuppression the most severe adverse effect; one patient had grade 3 anemia, one patient had grade 4 thrombocytopenia, and 12 patients had grade 4 neutropenia. Quality of life showed improvement over the course of therapy, particularly in the physical well-being subscale. CONCLUSION. The addition of hexamethylmelamine to paclitaxel and carboplatin is a well-tolerated multidrug combination for women with advanced ovarian cancer that deserves further testing in a phase III study.

Original languageEnglish
Pages (from-to)348-355
Number of pages8
JournalCancer Journal from Scientific American
Volume5
Issue number6
StatePublished - Nov 1 1999
Externally publishedYes

Fingerprint

Altretamine
Carboplatin
Paclitaxel
Ovarian Neoplasms
Therapeutics
Fallopian Tube Neoplasms
Colony-Stimulating Factors
Fallopian Tubes
Proxy
Neutropenia
Platinum
Gynecology
Antineoplastic Agents
Doxorubicin
Cyclophosphamide
Cisplatin
Obstetrics
Area Under Curve
Anemia
Neoplasms

Keywords

  • Altretamine
  • Carboplatin
  • Hexamethlymelamine
  • Ovarian cancer
  • Paclitaxel
  • Quality of life

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Hartenbach, E. M., Harris, L. S., Bailey, H. H., Grosen, E. A., Larrison, E., Chen, D., ... Schink, J. C. (1999). Paclitaxel, carboplatin, and hexamethylmelamine (Taxchex) as first-line therapy for ovarian cancer. Cancer Journal from Scientific American, 5(6), 348-355.

Paclitaxel, carboplatin, and hexamethylmelamine (Taxchex) as first-line therapy for ovarian cancer. / Hartenbach, Ellen M.; Harris, L. S.; Bailey, H. H.; Grosen, E. A.; Larrison, E.; Chen, D.; Twiggs, L. B.; Schink, J. C.

In: Cancer Journal from Scientific American, Vol. 5, No. 6, 01.11.1999, p. 348-355.

Research output: Contribution to journalArticle

Hartenbach, EM, Harris, LS, Bailey, HH, Grosen, EA, Larrison, E, Chen, D, Twiggs, LB & Schink, JC 1999, 'Paclitaxel, carboplatin, and hexamethylmelamine (Taxchex) as first-line therapy for ovarian cancer', Cancer Journal from Scientific American, vol. 5, no. 6, pp. 348-355.
Hartenbach EM, Harris LS, Bailey HH, Grosen EA, Larrison E, Chen D et al. Paclitaxel, carboplatin, and hexamethylmelamine (Taxchex) as first-line therapy for ovarian cancer. Cancer Journal from Scientific American. 1999 Nov 1;5(6):348-355.
Hartenbach, Ellen M. ; Harris, L. S. ; Bailey, H. H. ; Grosen, E. A. ; Larrison, E. ; Chen, D. ; Twiggs, L. B. ; Schink, J. C. / Paclitaxel, carboplatin, and hexamethylmelamine (Taxchex) as first-line therapy for ovarian cancer. In: Cancer Journal from Scientific American. 1999 ; Vol. 5, No. 6. pp. 348-355.
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abstract = "BACKGROUND. The addition of hexamethylmelamine to therapy with cisplatin, cyclophosphamide, and doxorubicin significantly enhanced outcomes of patients with advanced ovarian cancer. Hexamethylmelamine, also known as altretamine, has potent antineoplastic activity when used as a single agent in patients who have failed to respond to both platinum-based and paclitaxel therapy. We have conducted a pilot study to evaluate the efficacy and safety of adding this drug to the popular ovarian cancer regimen of paclitaxel plus carboplatin. METHODS. Patients with advanced ovarian, fallopian tube, or primary peritoneal cancer (International Federation of Gynecology and Obstetrics stages IIA, IIIC, and IV) were prospectively enrolled to receive six cycles, repeated every 4 weeks, of paclitaxel (150 mg/m2 IV, day 1), carboplatin (AUC 5.0 IV, day 1), and hexamethylmelamine (150 mg/m2 PO, days 2-15). Colony stimulating factors were prohibited. Response and toxicity were monitored by use of Eastern Cooperative Oncology Group criteria. RESULTS. Twenty patients were enrolled, 18 with ovarian cancer, one with fallopian tube cancer, and one with peritoneal cancer; 17 of these patients were evaluable for response and toxicity. At a median follow-up of 6.5 months, 13 of the patients had a complete response (76{\%}), and four had progressive disease. Three of those with a complete response had a recurrence within 1 year of completing treatment. Toxicity was acceptable, with myelosuppression the most severe adverse effect; one patient had grade 3 anemia, one patient had grade 4 thrombocytopenia, and 12 patients had grade 4 neutropenia. Quality of life showed improvement over the course of therapy, particularly in the physical well-being subscale. CONCLUSION. The addition of hexamethylmelamine to paclitaxel and carboplatin is a well-tolerated multidrug combination for women with advanced ovarian cancer that deserves further testing in a phase III study.",
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AU - Grosen, E. A.

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