The Oncologist, Vol. 11, No. 5, 532, May 2006; doi:10.1634/theoncologist.11-5-532
© 2006 AlphaMed Press
In Reply
Maurie Markman
University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
Correspondence:
Maurie Markman, M.D., University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA. Telephone: 713-745-7140; Fax: 713-563-9586; e-mail: mmarkman{at}mdanderson.org
Received March 10, 2006;
accepted for publication April 3, 2006.
In their letter, Muggia et al. [1] describe their experience with a "protracted continuous i.v. infusion schedule" of topotecan in the management of ovarian cancer. The authors suggest this may be an alternative strategy to either the U.S. Food and Drug Administration-approved regimen of 1.5 mg/m2 per day for 5 days, or a lower dose of 1.0–1.25 mg/m2 per day for 5 days, or a "weekly" topotecan treatment program.
While the information presented in this letter and in previous publications is certainly of interest, it is important to note the absence of data from phase III randomized trials demonstrating either the superior efficacy of this approach or even a reduction in toxicity compared with other strategies. Further, even the provocative data presented in this letter regarding the biological activity of the drug in previously heavily pretreated patients does not provide evidence that other, possibly far simpler, management programs might not have produced equivalent effects.
Exploration of novel methods of drug delivery should be strongly encouraged, for it is possible the clinical utility of specific anticancer drugs can be substantially improved through such efforts (e.g., the demonstrated superior impact of i.p. cisplatin in ovarian cancer). However, ultimately, the genuine benefits of such strategies must be documented in prospective randomized trials, especially when they are associated with the time, effort, cost, and toxicity of prolonged continuous infusional topotecan.
 |
DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST
|
|---|
The author indicates no potential conflicts of interest.
|
REFERENCES
|
|---|
- Muggia F, Kosloff R, Liebes L et al. Topotecan Continuous Infusion: CA-125 Responses Including Patients Pretreated with Other Schedules of Topotecan. The Oncologist 2006;11:529–531.[Free Full Text]
Top
Disclosure of Potential...
References
