Topotecan for endometrial cancer – pro

There are several trials of topotecan for recurrent metstatic uterine cancer with encouraging results.  For example, in a phase II trial, 29 patients were treated with topotecan 1.5 mg/m2 day on days 1-5 of a 21-day cycle. Of these patients, 61%, 39%, and 25% experienced grade 4 neutropenia, leukopenia, and thrombocytopenia, respectively. These preliminary results suggest that single-agent topotecan might have limited activity in patients with advanced or recurrent disease.

In an ongoing study, a regimen of weekly bolus i.v. topotecan is also being investigated in advanced recurrent metastatic endometrial carcinoma. In a preliminary report, 13 patients have tolerated weekly bolus i.v. topotecan at dose levels of 2.5-4.5 mg/m2/week. Fatigue was the most common nonhematologic toxicity, with 31% and 8% of patients experiencing grade 3 and 4 fatigue, respectively. Of the 13 patients, three have achieved a PR and six patients have died because of progressive disease. The weekly dosing schedule of topotecan appears to offer improved tolerability in this patient population compared with the 5-day topotecan dosing regimen. The authors of this article called for more studies.
Finkler NJ, Holloway RW. A phase I/II trial of weekly topotecan in the treatment of advanced recurrent metastatic endometrial carcinoma. Proc Am Soc Clin Oncol 2002;21:171b.

Tiffany A. Traina, Paul Sabbatini, Carol Aghajanian and Jakob Dupont,Weekly topotecan for recurrent endometrial cancer: a case series and review of the literature  Gynecologic Oncology
Volume 95, Issue 1, October 2004, Pages 235-241

Wadler, Scott, Levy, Donna E., Lincoln, Sarah T., Soori, Gamini S., Schink, Julian C., Goldberg, Gary
Topotecan Is an Active Agent in the First-Line Treatment of Metastatic or Recurrent Endometrial Carcinoma: Eastern Cooperative Oncology Group Study E3E93
J Clin Oncol 2003 21: 2110-2114

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