TY - JOUR
T1 - Salvage chemotherapy with taxane and platinum for women with recurrent uterine carcinosarcoma
AU - Matsuo, Koji
AU - Ross, Malcolm S.
AU - Yunokawa, Mayu
AU - Johnson, Marian S.
AU - Machida, Hiroko
AU - Omatsu, Kohei
AU - Klobocista, Merieme M.
AU - Im, Dwight D.
AU - Satoh, Shinya
AU - Baba, Tsukasa
AU - Ikeda, Yuji
AU - Bush, Stephen H.
AU - Hasegawa, Kosei
AU - Blake, Erin A.
AU - Takekuma, Munetaka
AU - Shida, Masako
AU - Nishimura, Masato
AU - Adachi, Sosuke
AU - Pejovic, Tanja
AU - Takeuchi, Satoshi
AU - Yokoyama, Takuhei
AU - Ueda, Yutaka
AU - Iwasaki, Keita
AU - Miyake, Takahito M.
AU - Yanai, Shiori
AU - Nagano, Tadayoshi
AU - Takano, Tadao
AU - Shahzad, Mian M.K.
AU - Ueland, Frederick R.
AU - Kelley, Joseph L.
AU - Roman, Lynda D.
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/12
Y1 - 2017/12
N2 - Objective To examine survival after recurrence (SAR) among women with recurrent uterine carcinosarcoma who received a taxane/platinum doublet as the first-line salvage chemotherapy. Methods We retrospectively examined 148 women with recurrent uterine carcinosarcoma who received salvage chemotherapy within a cohort of 906 uterine carcinosarcomas. An independent association of salvage chemotherapy type and SAR was examined with multivariate analysis. Results There were 71 (48.0%) women who received a taxane/platinum regimen. On univariate analysis, women who received a taxane/platinum doublet had a higher 2-year SAR rate compared to women who received non-taxane/platinum regimens (55.5% versus 34.8%, P < 0.001). On multivariate analysis, use of taxane/platinum regimen was independently associated with improved SAR compared to the non-taxane/platinum regimens (adjusted-hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.35 to 0.91, P = 0.02). When stratified by disease-free interval, women with a disease-free interval ≥ 6 months who received a taxane/platinum doublet had a higher 2-year SAR rate compared to those who received non-taxane/platinum regimens (61.9% versus 40.0%, HR 0.46, 95% CI 0.28 to 0.75, P = 0.002); conversely, in women with a disease-free interval < 6 months, 2-year SAR rates were similar between the two groups (20.5% versus 18.4%, HR 0.80, 95% CI 0.33 to 1.90, P = 0.61). Among women who received a taxane/platinum doublet as adjuvant chemotherapy, re-treatment with taxane/platinum doublet as salvage chemotherapy remained beneficial (2-year SAR rate, 62.1% versus 39.7%, HR 0.40, 95% CI 0.18 to 0.86, P = 0.019). Conclusion Our study suggests that taxane/platinum doublet may be a more effective chemotherapy regimen compared to other regimens among women with recurrent uterine carcinosarcoma, especially for those who had a disease-free interval of ≥ 6 months.
AB - Objective To examine survival after recurrence (SAR) among women with recurrent uterine carcinosarcoma who received a taxane/platinum doublet as the first-line salvage chemotherapy. Methods We retrospectively examined 148 women with recurrent uterine carcinosarcoma who received salvage chemotherapy within a cohort of 906 uterine carcinosarcomas. An independent association of salvage chemotherapy type and SAR was examined with multivariate analysis. Results There were 71 (48.0%) women who received a taxane/platinum regimen. On univariate analysis, women who received a taxane/platinum doublet had a higher 2-year SAR rate compared to women who received non-taxane/platinum regimens (55.5% versus 34.8%, P < 0.001). On multivariate analysis, use of taxane/platinum regimen was independently associated with improved SAR compared to the non-taxane/platinum regimens (adjusted-hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.35 to 0.91, P = 0.02). When stratified by disease-free interval, women with a disease-free interval ≥ 6 months who received a taxane/platinum doublet had a higher 2-year SAR rate compared to those who received non-taxane/platinum regimens (61.9% versus 40.0%, HR 0.46, 95% CI 0.28 to 0.75, P = 0.002); conversely, in women with a disease-free interval < 6 months, 2-year SAR rates were similar between the two groups (20.5% versus 18.4%, HR 0.80, 95% CI 0.33 to 1.90, P = 0.61). Among women who received a taxane/platinum doublet as adjuvant chemotherapy, re-treatment with taxane/platinum doublet as salvage chemotherapy remained beneficial (2-year SAR rate, 62.1% versus 39.7%, HR 0.40, 95% CI 0.18 to 0.86, P = 0.019). Conclusion Our study suggests that taxane/platinum doublet may be a more effective chemotherapy regimen compared to other regimens among women with recurrent uterine carcinosarcoma, especially for those who had a disease-free interval of ≥ 6 months.
KW - Chemotherapy
KW - Platinum
KW - Recurrence
KW - Survival outcome
KW - Taxane
KW - Uterine carcinosarcoma
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U2 - 10.1016/j.ygyno.2017.10.008
DO - 10.1016/j.ygyno.2017.10.008
M3 - Article
C2 - 29056442
AN - SCOPUS:85031742495
SN - 0090-8258
VL - 147
SP - 565
EP - 571
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 3
ER -