Efficacy and tolerability of lower-dose topotecan in recurrent ovarian cancer: A retrospective case review

Suann K. Mitchell, Linda F Carson, P. Judson, Levi S Downs

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations


Topotecan (1.5 mg/m2/day for 5 consecutive days of a 21-day cycle) is an established recurrent ovarian cancer treatment, but myelosuppression can be dose limiting. This study evaluates the activity and tolerability of low-dose topotecan in our clinical experience. Case records were reviewed for patients with recurrent ovarian cancer in first through third relapse. Eligible patients had received ≥2 cycles of ≤1.25 mg/m 2 topotecan. Adverse events were evaluated using laboratory and clinical evaluation data. Twenty-seven eligible patients, most with advanced disease, received a total of 209 cycles (median, six cycles). Grade 3 or 4 hematologic toxicities during 184 cycles in 24 assessed patients were neutropenia, leukopenia, thrombocytopenia, and anemia in 35%, 28%, 36%, and 11% of cycles, and 21, 19, 16, and 10 patients, respectively. Only four grade 4 toxicities occurred: anemia (one) and thrombocytopenia (three). Myelosuppression was reversible, noncumulative, and manageable. Moreover, nonhematologic toxicity was generally mild to moderate, and the only two grade 3 events were constipation and deep vein thrombosis. Low-dose topotecan was active in this setting. Lower-dose topotecan is generally well tolerated and active in patients with pretreated ovarian cancer. Prospective clinical trials of low-dose topotecan in recurrent ovarian cancer are warranted.

Original languageEnglish (US)
Pages (from-to)793-798
Number of pages6
JournalInternational Journal of Gynecological Cancer
Issue number5
StatePublished - Sep 2005


  • Alternate dosing
  • Myelosuppression
  • Ovarian cancer
  • Topoisomerase I
  • Topotecan


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