Abstract:

Objective    To observe the efficacy and side effect of pemetrexed(PEM) alone or in combination with nedaplatin(NDP) in recurrence and carboplatin(CBP) and paclitaxel(PTX) resistance advanced epithelial ovarian carcinoma. Methods    Fifty patients with recurrence and CBP and PTX resistance advanced epithelial ovarian carcinoma were randomly divided into groups A and B. Twenty-five patients in group A were treated only with PEM 500mg/m2 on day 1 which was repeated every 21 days,  and twenty-five patients in group B were treated with PEM 500mg/m2，and NDP 80g/m2 on day 1 which was repeated every 21 days,  until disease had progressed. ResultsNo patients achieved  complete response (CR) in either group but 4 patients in group A(or 11 patients in group B) achieved a partial response (PR) and 15 patients in group A(or 11 patients in group B) achieved a stable disease (SD) and the overall response rate(ORR) was 16.0% in group A and 44.0% in group B(χ2=4.667，P＝0.031). The median time to progression(mTTP) was respectively 2.4  months in group A and 3.6 months in group B(P=0.046) and the median survival (mS) was 6.0 months in group A and 7.5 months in group B(Log-rank，P＝0.048). The major adverse effect was marrow depression. Conclusions    PEM alone or in combination with NDP were effective for recurrence and CBP/PTX resistance in advanced epithelial ovarian carcinoma. The ORR,  mTTP and mS of PEM in combination with NDP was significantly better than PEM alone and marrow depression was marked,  but tolerated. 

Key words: Ovarian neoplasms; Medical treatment; Pemetrexed; Nedaplatin; Treatment outcome