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What is an appropriate second-line regimen for recurrent endometrial cancer? Ancillary analysis of the SGSG012/GOTIC004/Intergroup study

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Abstract

Purpose

We previously reported that the concept of “platinum sensitivity” could be applied to recurrent endometrial cancer. We conducted an ancillary analysis to determine an appropriate second-line regimen for patients who received a platinum agent as first-line chemotherapy.

Methods

We extracted and reanalyzed data of patients treated with doxorubicin and cisplatin (AP), paclitaxel and carboplatin (TC), or docetaxel and carboplatin (DC) as first- and second-line chemotherapies from the SGSG012/GOTIC004/Intergroup study.

Results

We identified 216 patients: 38 received AP as first-line chemotherapy, of which 36 received TC or DC (Tax-C) as second-line chemotherapy; and 178 received Tax-C as first-line chemotherapy, of which 51 received AP and 127 received Tax-C as second-line chemotherapy. Median progression-free survival (PFS) and overall survival (OS) after second-line chemotherapy decreased in the order of Tax-C followed by Tax-C (10 and 48 months, respectively), AP followed by Tax-C (9 and 23 months, respectively), and Tax-C followed by AP (3 and 12 months, respectively). Median PFS and OS after second-line chemotherapy for platinum-resistant patients receiving Tax-C as first-line chemotherapy were longer in Tax-C than in AP (7 and 23 vs. 3 and 10 months, respectively) as second-line chemotherapy [hazard ratio (HR) 3.255, 95 % confidence interval (CI) 1.908–5.555, p < 0.0001; HR 3.179, 95 % CI 1.835–5.507, p < 0.0001, respectively]. Median PFS and OS after second-line chemotherapy for platinum-sensitive patients receiving Tax-C as first-line chemotherapy were almost equivalent to those receiving Tax-C or AP as second-line chemotherapy.

Conclusions

For platinum-resistant recurrent endometrial cancer patients, Tax-C may be preferred over AP as second-line chemotherapy.

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Acknowledgments

We wish to thank each of the trial collaborators (listed alphabetically by name): Hideo Fujimoto, JA Hiroshima General Hospital; Masayuki Futagami, Hirosaki University; Kiyoshi Hasegawa, Fujita Health University; Atsushi Hongo, Okayama University; Huminori Ito, Nara Prefectural Nara Hospital; Yasunori Kanamori, Yamaguchi Red Cross Hospital; Fumiharu Miura, Iwate Medical University; Atsushi Okada, Nagoya City University; Masumi Okada, Health Insurance Naruto Hospital; Takashi Oshita, Miyoshi Central Hospital; Isao Sekiguchi, Tochigi Prefectural Cancer Center; Naoya Shigeta, Kansai Rosai Hospital; Kazuhiro Takehara, Hiroshima University; Hiroshi Tsubamoto, Hyogo Medical University; and Kaneda Yoshifumi, Health Insurance Saitama Hospital.

Conflict of interest

The authors declare that there are no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Gynecologic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi City, Hyogo, 673-8558, Japan

    Shoji Nagao & Kiyoshi Fujiwara

  2. Department of Obstetrics and Gynecology, Kurume University School of Medicine, 67 Asahi-machi, Kurume City, Fukuoka, 830-0011, Japan

    Shin Nishio

  3. Department of Obstetrics and Gynecology, Tsukuba University, 1-1-1 Tennodai, Tsukuba City, Ibaraki, 305-8575, Japan

    Satoshi Okada

  4. Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Seiryo-machi, Aoba-ku, Sendai City, Miyagi, 980-8574, Japan

    Takeo Otsuki

  5. Department of Obstetrics and Gynecology, Jikei University Kashiwa Hospital, 163-1 Kashiwasita, Kashiwa City, Chiba, 277-8567, Japan

    Hiroshi Tanabe

  6. Department of Obstetrics and Gynecology, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan

    Masashi Takano

  7. Department of Gynecologic Oncology, Saitama Cancer Center, 818 Komuro, Ina-machi, Kitaadachi, Saitama, 362-0806, Japan

    Yoko Hasumi

  8. Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke City, Tochigi, 329-0498, Japan

    Yuji Takei & Mitsuaki Suzuki

  9. Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Tetsuya Hasegawa

  10. Department of Gynecologic Oncology, Shikoku Cancer Center, 160 Minami-Umemoto, Matsuyama City, Ehime, 791-0280, Japan

    Takashi Matsumoto

  11. Department of Gynecologic Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-City, 350-1241, Japan

    Keiichi Fujiwara

  12. Department of Gynecologic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Shizuoka, 411-8777, Japan

    Munetaka Takekuma

  13. Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi City, Gunma, 371-8511, Japan

    Kazuto Nakamura

  14. Department of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishi-cho, Yonago City, Tottori, 683-8504, Japan

    Muneaki Shimada

  15. Matsue City Hospital, 32-1 Noshiro-cho, Matsue, 690-8509, Japan

    Junzo Kigawa

Authors
  1. Shoji Nagao
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  2. Shin Nishio
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  3. Satoshi Okada
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  4. Takeo Otsuki
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  5. Kiyoshi Fujiwara
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  6. Hiroshi Tanabe
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  7. Masashi Takano
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  8. Yoko Hasumi
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  9. Yuji Takei
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  10. Tetsuya Hasegawa
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  11. Takashi Matsumoto
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  12. Keiichi Fujiwara
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  13. Munetaka Takekuma
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  14. Kazuto Nakamura
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  15. Muneaki Shimada
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  16. Mitsuaki Suzuki
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  17. Junzo Kigawa
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Corresponding author

Correspondence to Shoji Nagao.

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Nagao, S., Nishio, S., Okada, S. et al. What is an appropriate second-line regimen for recurrent endometrial cancer? Ancillary analysis of the SGSG012/GOTIC004/Intergroup study. Cancer Chemother Pharmacol 76, 335–342 (2015). https://doi.org/10.1007/s00280-015-2793-9

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  • DOI: https://doi.org/10.1007/s00280-015-2793-9

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