Salvage chemotherapy with taxane and platinum for women with recurrent uterine carcinosarcoma

Gynecol Oncol. 2017 Dec;147(3):565-571. doi: 10.1016/j.ygyno.2017.10.008. Epub 2017 Oct 20.

Abstract

Objective: To examine survival after recurrence (SAR) among women with recurrent uterine carcinosarcoma who received a taxane/platinum doublet as the first-line salvage chemotherapy.

Methods: We retrospectively examined 148 women with recurrent uterine carcinosarcoma who received salvage chemotherapy within a cohort of 906 uterine carcinosarcomas. An independent association of salvage chemotherapy type and SAR was examined with multivariate analysis.

Results: There were 71 (48.0%) women who received a taxane/platinum regimen. On univariate analysis, women who received a taxane/platinum doublet had a higher 2-year SAR rate compared to women who received non-taxane/platinum regimens (55.5% versus 34.8%, P<0.001). On multivariate analysis, use of taxane/platinum regimen was independently associated with improved SAR compared to the non-taxane/platinum regimens (adjusted-hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.35 to 0.91, P=0.02). When stratified by disease-free interval, women with a disease-free interval ≥6months who received a taxane/platinum doublet had a higher 2-year SAR rate compared to those who received non-taxane/platinum regimens (61.9% versus 40.0%, HR 0.46, 95% CI 0.28 to 0.75, P=0.002); conversely, in women with a disease-free interval <6months, 2-year SAR rates were similar between the two groups (20.5% versus 18.4%, HR 0.80, 95% CI 0.33 to 1.90, P=0.61). Among women who received a taxane/platinum doublet as adjuvant chemotherapy, re-treatment with taxane/platinum doublet as salvage chemotherapy remained beneficial (2-year SAR rate, 62.1% versus 39.7%, HR 0.40, 95% CI 0.18 to 0.86, P=0.019).

Conclusion: Our study suggests that taxane/platinum doublet may be a more effective chemotherapy regimen compared to other regimens among women with recurrent uterine carcinosarcoma, especially for those who had a disease-free interval of ≥6months.

Keywords: Chemotherapy; Platinum; Recurrence; Survival outcome; Taxane; Uterine carcinosarcoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bridged-Ring Compounds / administration & dosage
  • Carcinosarcoma / drug therapy*
  • Carcinosarcoma / mortality
  • Cohort Studies
  • Female
  • Humans
  • Japan / epidemiology
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / mortality
  • Organoplatinum Compounds / administration & dosage
  • Retrospective Studies
  • Salvage Therapy
  • Taxoids / administration & dosage
  • United States / epidemiology
  • Uterine Neoplasms / drug therapy*
  • Uterine Neoplasms / mortality

Substances

  • Bridged-Ring Compounds
  • Organoplatinum Compounds
  • Taxoids
  • taxane