Salvage chemotherapy with taxane and platinum for women with recurrent uterine carcinosarcoma

Koji Matsuo, Malcolm S Ross, Mayu Yunokawa, Marian S Johnson, Hiroko Machida, Kohei Omatsu, Merieme M Klobocista, Dwight D Im, Shinya Satoh, Tsukasa Baba, Yuji Ikeda, Stephen H Bush, Kosei Hasegawa, Erin A Blake, Munetaka Takekuma, Masako Shida, Masato Nishimura, Sosuke Adachi, Tanja Pejovic, Satoshi TakeuchiTakuhei Yokoyama, Yutaka Ueda, Keita Iwasaki, Takahito M Miyake, Shiori Yanai, Tadayoshi Nagano, Tadao Takano, Mian M K Shahzad, Frederick R Ueland, Joseph L Kelley, Lynda D Roman

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

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 ≥6months 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 <6months, 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 ≥6months.

Original languageEnglish
Pages (from-to)565-571
Number of pages7
JournalGynecologic Oncology
Volume147
Issue number3
DOIs
Publication statusPublished - Dec 2017
Externally publishedYes

Keywords

  • Antineoplastic Combined Chemotherapy Protocols/therapeutic use
  • Bridged-Ring Compounds/administration & dosage
  • Carcinosarcoma/drug therapy
  • Cohort Studies
  • Female
  • Humans
  • Japan/epidemiology
  • Middle Aged
  • Neoplasm Recurrence, Local/drug therapy
  • Organoplatinum Compounds/administration & dosage
  • Retrospective Studies
  • Salvage Therapy
  • Taxoids/administration & dosage
  • United States/epidemiology
  • Uterine Neoplasms/drug therapy

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  • Cite this

    Matsuo, K., Ross, M. S., Yunokawa, M., Johnson, M. S., Machida, H., Omatsu, K., Klobocista, M. M., Im, D. D., Satoh, S., Baba, T., Ikeda, Y., Bush, S. H., Hasegawa, K., Blake, E. A., Takekuma, M., Shida, M., Nishimura, M., Adachi, S., Pejovic, T., ... Roman, L. D. (2017). Salvage chemotherapy with taxane and platinum for women with recurrent uterine carcinosarcoma. Gynecologic Oncology, 147(3), 565-571. https://doi.org/10.1016/j.ygyno.2017.10.008