Combining bone marrow transplant with high-dose chemotherapy improves survival rates for women with advanced ovarian cancer, according to researchers at Loyola University Medical Center, Chicago.
Of 30 women whose cancers failed to respond successfully to prior chemotherapy treatments and who then underwent the innovative therapy, 23% remained alive and disease-free after 3 years. Only one death occurred during treatment.
"This represents a significant success, considering that until now the long-term prognosis was essentially zero for a woman who developed recurrent or drug-resistant ovarian cancer," said Dr. Patrick Stiff, director of bone marrow transplantation at Loyola and the principal investigator of the study.
Program paticipants ranged in age from 30 to 64. Each received high doses of mitoxantrone(Drug information on mitoxantrone) (Novantrone), carboplatin (Paraplatin), and cyclophosphamide(Drug information on cyclophosphamide) (Cytoxan, Neosar) after stem cells were first removed from their bone marrow. Following the high-dose chemotherapy, the preserved stem cells were reinfused in the patient.
"Right now, we are looking at survival rates of only 10% to 20% on average for ovarian cancer, when applying conventional treatments," Stiff indicated. "The use of Taxol may improve survival somewhat, but not by more than a few percentage points."
Nearly one-quarter of the study participants, all of whom were drawn from the population of patients with recurrent or drug-resistant ovarian cancer, remained disease-free even after 3 years, Stiff said. In fact, more than 80% of the patients initially experienced remission of their cancers in response to the therapy; median survival was 29 months.
"We are undertaking further studies to determine whether using this same combination of drugs and transplantation can improve survival rates even more when given to patients at the outset, before they have developed recurrent or drug-resistant stages of the disease," Stiff said.
The study represents the second phase of work that Stiff began in 1989 as the single largest program of its kind in the nation, according to a spokesperson for Loyola. The early work not only established the potential effectiveness of the combination therapy but also provided a profile of the patient who would likely benefit most from the treatment.
A full report on the study appears in the June issue of Gynecologic Oncology.
A 70-year-old man with a history of localized prostate cancer treated with whole-pelvis radiation therapy with a boost to the prostate, in conjunction with androgen deprivation therapy 7 years prior, presented with lower back pain. A bone scan revealed an area of activity in the sacrum. What is the most likely diagnosis?
