当前位置： SCI文献检索 > BRITISH JOURNAL OF CANCER期刊下所有文献 > A randomised, phase II trial of the DNA-hypomethylating agent 5-aza-2'-deoxycytidine (decitabine) in combination with carboplatin vs carboplatin alone in patients with recurrent, partially platinum-sensitive ovarian cancer.

A randomised, phase II trial of the DNA-hypomethylating agent 5-aza-2'-deoxycytidine (decitabine) in combination with carboplatin vs carboplatin alone in patients with recurrent, partially platinum-sensitive ovarian cancer.

Abstract：

BACKGROUND:Our previous laboratory and clinical data suggested that one mechanism underlying the development of platinum resistance in ovarian cancer is the acquisition of DNA methylation. We therefore tested the hypothesis that the DNA hypomethylating agent 5-aza-2'-deoxycytodine (decitabine) can reverse resistance to carboplatin in women with relapsed ovarian cancer. METHODS:Patients progressing 6-12 months after previous platinum therapy were randomised to decitabine on day 1 and carboplatin (AUC 6) on day 8, every 28 days or carboplatin alone. The primary objective was response rate in patients with methylated hMLH1 tumour DNA in plasma. RESULTS:After a pre-defined interim analysis, the study closed due to lack of efficacy and poor treatment deliverability in 15 patients treated with the combination. Responses by GCIG criteria were 9 out of 14 vs 3 out of 15 and by RECIST were 6 out of 13 vs 1 out of 12 for carboplatin and carboplatin/decitabine, respectively. Grade 3/4 neutropenia was more common with the combination (60% vs 15.4%) as was G2/3 carboplatin hypersensitivity (47% vs 21%). CONCLUSIONS:With this schedule, the addition of decitabine appears to reduce rather than increase the efficacy of carboplatin in partially platinum-sensitive ovarian cancer and is difficult to deliver. Patient-selection strategies, different schedules and other demethylating agents should be considered in future combination studies.

journal_name

Br J Cancer

journal_title

British journal of cancer

authors

Glasspool RM,Brown R,Gore ME,Rustin GJ,McNeish IA,Wilson RH,Pledge S,Paul J,Mackean M,Hall GD,Gabra H,Halford SE,Walker J,Appleton K,Ullah R,Kaye S,Scottish Gynaecological Trials Group.

doi

10.1038/bjc.2014.116

subject

Has Abstract

pub_date

2014-04-15 00:00:00

pages

1923-9

issue

8

eissn

0007-0920

issn

1532-1827

pii

bjc2014116

journal_volume

110

pub_type

杂志文章,随机对照试验

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