Long Term Oral Etoposide as Second Line Therapy in Recurrent Epithelial Carcinoma of the Ovary

There is a continuing need to identify new agents that are active in ovarian cancer. Etoposide is a derivative of the plant alkaloid epipodophyllotoxin. The availability of etoposide in oral preparation allows prolonged administration by the oral route. In this study, activity and toxicity of etoposide in women with recurrent ovarian cancer are described from a case series of women with recurrent ovarian cancer who had measurable disease. All patients had prior platinum-based chemotherapy and developed progressive disease. Oral etoposide was given as 50 mg/day for 21 days every 4 weeks until progression of disease or prohibitive toxicity. From December 1999 to January 2004, 32 patients were enrolled in this study. Thirty patients received a total of 133 cycles of etoposide. Median age of patients was 49 years (range, 19 to 75). The median number of etoposide cycles was 4 (range, 1 to 12). There were 5 partial responses (16.6%). The mean response duration was 4.8 months (range, 3.5 to 6); median progression-free interval was 7 months (range, 3 to 13) and median survival time was 12.5 months (range, 1.3 to 36). The major toxicity was leukopenia. One patient required red blood cell transfusions and the main non-hematologic toxicity was nausea and vomiting. There were no treatment-related mortalities. Although etoposide appears to exhibit modest activity in recurrent ovarian cancer after platinum-based therapy, response and survival durations are short. Acta Medica Iranica, 44(1): 7-12; 2006 © 2006 Tehran University of Medical Sciences. All rights reserved.