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 journalArticlepeer-review

8 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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