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Hexamethylmelamine as consolidation treatment for patients with advanced epithelial ovarian cancer in complete response after first-line chemotherapy.

Kwon YS, Nam JH, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT - J. Korean Med. Sci. (2009)

Bottom Line: Of 102 patients enrolled, 49 were treated with HMM and 53 received no consolidation treatment.For patients with HMM and observed patients, the mean age were 54.6 and 55.6 yr; the distribution of stage was similar (P=0.977); the optimal surgery was performed in 36 (73.5%) and 44 (83%) (P=0.336); the recurrence rate were 27 (55.1%) and 33 (62.3%) (P=0.463); and the median progression-free survival were 38 months and 21 months for patients with HMM and observed patients (P=0.235).No treatment-related adverse events were reported during the follow-up period.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.

ABSTRACT
The aim of this study was to assess the efficacy of consolidation therapy with hexamethylmelamine (HMM) in patients with advanced epithelial ovarian cancer (EOC). Patients treated at our hospital between January 1997 and November 2006 and in documented clinical complete response from advanced ovarian cancer following front-line platinum-based therapy were retrospectively analyzed. The patients treated with HMM were compared to the patients of matched counterpart without consolidation therapy. Of 102 patients enrolled, 49 were treated with HMM and 53 received no consolidation treatment. For patients with HMM and observed patients, the mean age were 54.6 and 55.6 yr; the distribution of stage was similar (P=0.977); the optimal surgery was performed in 36 (73.5%) and 44 (83%) (P=0.336); the recurrence rate were 27 (55.1%) and 33 (62.3%) (P=0.463); and the median progression-free survival were 38 months and 21 months for patients with HMM and observed patients (P=0.235). No treatment-related adverse events were reported during the follow-up period. Although this study failed to show the significant survival benefit of consolidation therapy with HMM in patients with advanced EOC, we consider that our study can contribute data to investigate the effectiveness of consolidation therapy in epithelial ovarian cancer.

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Progression-free survival of patients with suboptimal debulked disease (residual tumor ≥1 cm), treated or untreated with HMM.
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Figure 3: Progression-free survival of patients with suboptimal debulked disease (residual tumor ≥1 cm), treated or untreated with HMM.

Mentions: Of patients with optimal debulked disease (residual tumor <1 cm), those who received consolidation treatment had a median PFS of 41 months (95% CI 25-57 months), whereas those who received no treatment had a median PFS of 25 months (95% CI 19-31 months), but there was no significant difference (P=0.333) (Fig. 2). Of patients with suboptimal debulked disease (residual tumor ≥1 cm), median PFS of those who did and did not receive HMM were 16 months (95% CI 10-22 months) and 16 months (95% CI 12-20 months), respectively (P=0.204) (Fig. 3). Using Cox's proportional hazards model, we found that serum CA-125 concentration 6 weeks after initiation of first-line therapy, which means just before the 3rd cycle of adjuvant chemotherapy (P<0.0001), stage (P=0.005), and debulking status (P=0.038) were significant prognostic factors for PFS (Table 2). Gastrointestinal toxicity was the prominent feature in our study group. Four patients discontinued consolidation therapy due to grade 4 toxicity. But most patients with HMM were tolerable during the follow-up period.


Hexamethylmelamine as consolidation treatment for patients with advanced epithelial ovarian cancer in complete response after first-line chemotherapy.

Kwon YS, Nam JH, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT - J. Korean Med. Sci. (2009)

Progression-free survival of patients with suboptimal debulked disease (residual tumor ≥1 cm), treated or untreated with HMM.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2719200&req=5

Figure 3: Progression-free survival of patients with suboptimal debulked disease (residual tumor ≥1 cm), treated or untreated with HMM.
Mentions: Of patients with optimal debulked disease (residual tumor <1 cm), those who received consolidation treatment had a median PFS of 41 months (95% CI 25-57 months), whereas those who received no treatment had a median PFS of 25 months (95% CI 19-31 months), but there was no significant difference (P=0.333) (Fig. 2). Of patients with suboptimal debulked disease (residual tumor ≥1 cm), median PFS of those who did and did not receive HMM were 16 months (95% CI 10-22 months) and 16 months (95% CI 12-20 months), respectively (P=0.204) (Fig. 3). Using Cox's proportional hazards model, we found that serum CA-125 concentration 6 weeks after initiation of first-line therapy, which means just before the 3rd cycle of adjuvant chemotherapy (P<0.0001), stage (P=0.005), and debulking status (P=0.038) were significant prognostic factors for PFS (Table 2). Gastrointestinal toxicity was the prominent feature in our study group. Four patients discontinued consolidation therapy due to grade 4 toxicity. But most patients with HMM were tolerable during the follow-up period.

Bottom Line: Of 102 patients enrolled, 49 were treated with HMM and 53 received no consolidation treatment.For patients with HMM and observed patients, the mean age were 54.6 and 55.6 yr; the distribution of stage was similar (P=0.977); the optimal surgery was performed in 36 (73.5%) and 44 (83%) (P=0.336); the recurrence rate were 27 (55.1%) and 33 (62.3%) (P=0.463); and the median progression-free survival were 38 months and 21 months for patients with HMM and observed patients (P=0.235).No treatment-related adverse events were reported during the follow-up period.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.

ABSTRACT
The aim of this study was to assess the efficacy of consolidation therapy with hexamethylmelamine (HMM) in patients with advanced epithelial ovarian cancer (EOC). Patients treated at our hospital between January 1997 and November 2006 and in documented clinical complete response from advanced ovarian cancer following front-line platinum-based therapy were retrospectively analyzed. The patients treated with HMM were compared to the patients of matched counterpart without consolidation therapy. Of 102 patients enrolled, 49 were treated with HMM and 53 received no consolidation treatment. For patients with HMM and observed patients, the mean age were 54.6 and 55.6 yr; the distribution of stage was similar (P=0.977); the optimal surgery was performed in 36 (73.5%) and 44 (83%) (P=0.336); the recurrence rate were 27 (55.1%) and 33 (62.3%) (P=0.463); and the median progression-free survival were 38 months and 21 months for patients with HMM and observed patients (P=0.235). No treatment-related adverse events were reported during the follow-up period. Although this study failed to show the significant survival benefit of consolidation therapy with HMM in patients with advanced EOC, we consider that our study can contribute data to investigate the effectiveness of consolidation therapy in epithelial ovarian cancer.

Show MeSH
Related in: MedlinePlus