Hexamethylmelamine for the treatment of ovarian cancer--the Mount Sinai experience.

Abstract:

:Two regimens were tested, CHAP I and CHAP II, the latter, a hexamethylmelamine dosage-intensive regimen, first as second line (salvage) therapy and then as primary therapy. Both produced the most successful results achieved in the Mount Sinai series up to the time of their introduction, when compared to their predecessor regimens: CAP, AP and P. In an overall interim comparison, CHAP II was significantly superior to historical AP and CAP as primary therapy, as was CHAP I vs. AP in several important subgroups compared as part of a randomized trial. CHAP II overall progression-free survival was improved in spite of added new sensitive test methods. Salvage therapy also improved markedly with the addition of intensive hexamethylmelamine. Several biological and treatment characteristics strongly influenced outcome, especially young age and adding hexamethylmelamine. Other possible factors included: poor tumor grade, poor performance status, and extent of surgical debulking, even to intermediate residual, 2-6 cm size [CHAP II only]; extensive (optimum) surgery [CHAP I only]. The hexamethylmelamine-containing regimens interact favorably with some of these factors, better than did the preceding regimens. Five-year follow-up analyses weakened slightly for extensive surgery, intermediate size and poorly differentiated tumors. It confirmed and strengthened several findings favoring CHAP I & II, the hexamethylmelamine-containing regimens.

journal_name

Cancer Treat Rev

journal_title

Cancer treatment reviews

authors

Bruckner HW,Cohen C,Mandeli J,Chesser MR,Kabakow B,Wallach R,Holland J

doi

10.1016/0305-7372(91)90025-u

subject

Has Abstract

pub_date

1991-03-01 00:00:00

pages

57-65

eissn

0305-7372

issn

1532-1967

pii

0305-7372(91)90025-U

journal_volume

18 Suppl A

pub_type

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