506 The Second Line Chemotherapy for The Ovarian Carcinoma After The First Line Chemotherapy With The Combination of Paclitaxel and Carboplatin

Present studies were designed to evaluate the optimal second-line chemotherapy after the combination of paclitaxel and carboplatin as the first-line chemotherapy. Patients with TFI more than 48 weeks and between 24 and 48 weeks responded remarkably with the administration of Pac/Carbo repetitively (RR 59%). in contrast, patients who recurred within 24 weeks after the first-line Pac/ Carbo chemotherapy (resistant to Pac/Carbo) or who did not respond to the initial Pac/Carbo chemotherapy (refractory to Pac/ Carbo) did not respond well to the any regimen of the second-line chemotherapy with a response rate of 6% and 9%, respectively. Prospective multi-institutional study (GOGO-Ov2) was designed in an effort to improve the survival of those who are refractory or resistant to the first-line chemotherapy with Pac/Carbo.CPT-11 and Docetaxel were administered at 60 mg/m2 and 30 mg/m2, respectively at days 1 and 8 in every 3 weeks for at least two courses. Primary endpoint was a clinical response and secondary endpoints were toxicity, progression free survival, and overall survival. to date, 22 refractory cases and 14 resistant cases (including 5 cases which is diagnosed as resistant by the evaluation of serum CA125 level) were registered. Severe toxicity (Grade > 3) was as follows: (leukopenia 28%, neutropenia 33%, thrombocytopenia 8%, anemia 11%, diarrhea 6%). Clinical responses were evaluated in 25 cases. Three of 17 refractory cases and 2 of 8 resistant cases responded partially with a response rate of 18% and 25%, respectively. The combination of CPT-11 and Docetaxel may be useful to those who are refractory or resistant to the ‘standard’ first line chemotherapy.