Difference between revisions of "Endometrial cancer"
m (Text replacement - "<span style="background:#00CD00; padding:3px 6px 3px 6px; border-color:black; border-width:2px; border-style:solid;">Randomized Phase II</span>" to "style="background-color:#00CD00"|Randomized Phase II") |
m (Text replacement - "<span style="background:#00CD00; padding:3px 6px 3px 6px; border-color:black; border-width:2px; border-style:solid;">Phase III</span>" to "style="background-color:#00CD00"|Phase III") |
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|[http://jco.ascopubs.org/content/17/6/1736.long Thigpen et al. 1999] | |[http://jco.ascopubs.org/content/17/6/1736.long Thigpen et al. 1999] | ||
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|High-dose medroxyprogesterone acetate | |High-dose medroxyprogesterone acetate | ||
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|[http://www.gynecologiconcology-online.net/article/S0090-8258(08)00938-4/abstract Homesley et al. 2008 (GOG 184)] | |[http://www.gynecologiconcology-online.net/article/S0090-8258(08)00938-4/abstract Homesley et al. 2008 (GOG 184)] | ||
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|[[Uterine_cancer#Cisplatin.2C_Doxorubicin.2C_Paclitaxel.2C_RT|Cisplatin, Doxorubicin, Paclitaxel, RT]] | |[[Uterine_cancer#Cisplatin.2C_Doxorubicin.2C_Paclitaxel.2C_RT|Cisplatin, Doxorubicin, Paclitaxel, RT]] | ||
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|[http://www.gynecologiconcology-online.net/article/S0090-8258(08)00938-4/abstract Homesley et al. 2008 (GOG 184)] | |[http://www.gynecologiconcology-online.net/article/S0090-8258(08)00938-4/abstract Homesley et al. 2008 (GOG 184)] | ||
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|[[Uterine_cancer#Cisplatin.2C_Doxorubicin.2C_RT|Cisplatin, Doxorubicin, RT]] | |[[Uterine_cancer#Cisplatin.2C_Doxorubicin.2C_RT|Cisplatin, Doxorubicin, RT]] | ||
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|[http://jco.ascopubs.org/content/22/11/2159.long Fleming et al. 2004 (GOG 177)] | |[http://jco.ascopubs.org/content/22/11/2159.long Fleming et al. 2004 (GOG 177)] | ||
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|[[Uterine_cancer#Cisplatin.2C_Doxorubicin.2C_Paclitaxel|Cisplatin, Doxorubicin, Paclitaxel]] | |[[Uterine_cancer#Cisplatin.2C_Doxorubicin.2C_Paclitaxel|Cisplatin, Doxorubicin, Paclitaxel]] | ||
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|[http://jco.ascopubs.org/content/24/1/36.long Randall et al. 2006 (GOG 122)] | |[http://jco.ascopubs.org/content/24/1/36.long Randall et al. 2006 (GOG 122)] | ||
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|[[Uterine_cancer#Whole_abdominal_radiation_.28WAI.29|Whole abdominal irradiation]] | |[[Uterine_cancer#Whole_abdominal_radiation_.28WAI.29|Whole abdominal irradiation]] | ||
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|[http://jco.ascopubs.org/content/22/11/2159.long Fleming et al. 2004 (GOG 177)] | |[http://jco.ascopubs.org/content/22/11/2159.long Fleming et al. 2004 (GOG 177)] | ||
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|[[Uterine_cancer#Cisplatin_.26_Doxorubicin|Cisplatin & Doxorubicin]] | |[[Uterine_cancer#Cisplatin_.26_Doxorubicin|Cisplatin & Doxorubicin]] | ||
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|[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2752331 Wolfson et al. 2007 (GOG 150)] | |[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2752331 Wolfson et al. 2007 (GOG 150)] | ||
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|[[Uterine_cancer#Whole_abdominal_radiation_.28WAI.29|Whole abdominal irradiation]] | |[[Uterine_cancer#Whole_abdominal_radiation_.28WAI.29|Whole abdominal irradiation]] | ||
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|[http://jco.ascopubs.org/content/25/5/526.long Homesley et al. 2007 (GOG 161)] | |[http://jco.ascopubs.org/content/25/5/526.long Homesley et al. 2007 (GOG 161)] | ||
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|[[Uterine_cancer#Ifosfamide_.26_Paclitaxel|Ifosfamide & Paclitaxel]] | |[[Uterine_cancer#Ifosfamide_.26_Paclitaxel|Ifosfamide & Paclitaxel]] | ||
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|[http://jco.ascopubs.org/content/25/5/526.long Homesley et al. 2007 (GOG 161)] | |[http://jco.ascopubs.org/content/25/5/526.long Homesley et al. 2007 (GOG 161)] | ||
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|[[Uterine_cancer#Ifosfamide|Ifosfamide]] | |[[Uterine_cancer#Ifosfamide|Ifosfamide]] | ||
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|[http://jco.ascopubs.org/content/24/1/36.long Randall et al. 2006 (GOG 122)] | |[http://jco.ascopubs.org/content/24/1/36.long Randall et al. 2006 (GOG 122)] | ||
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|[[Uterine_cancer#Cisplatin_.26_Doxorubicin|Cisplatin & Doxorubicin]] | |[[Uterine_cancer#Cisplatin_.26_Doxorubicin|Cisplatin & Doxorubicin]] | ||
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|[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2752331 Wolfson et al. 2007 (GOG 150)] | |[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2752331 Wolfson et al. 2007 (GOG 150)] | ||
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|[[Uterine_cancer#Cisplatin.2C_Ifosfamide.2C_Mesna_.28CIM.29|CIM]] | |[[Uterine_cancer#Cisplatin.2C_Ifosfamide.2C_Mesna_.28CIM.29|CIM]] | ||
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Revision as of 06:52, 25 October 2016
Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer.
Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are invited to contribute to the site.
35 regimens on this page
55 variants on this page
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Endocrine therapy for endometrioid histologies
Anastrozole (Arimidex)
back to top |
Regimen
Study | Evidence |
Rose et al. 2000 | Phase II |
Endocrine therapy
- Anastrozole (Arimidex) 1 mg PO once per day
given until progression of disease or unacceptable toxicity
References
- Rose PG, Brunetto VL, VanLe L, Bell J, Walker JL, Lee RB. A phase II trial of anastrozole in advanced recurrent or persistent endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2000 Aug;78(2):212-6. link to original article contains verified protocol PubMed
Medroxyprogesterone acetate (MPA)
back to top |
Regimen
Study | Evidence | Comparator |
Thigpen et al. 1999 | Phase III | High-dose medroxyprogesterone acetate |
Endocrine therapy
- Medroxyprogesterone acetate (MPA) 200 mg PO once per day
Given until progression of disease or unacceptable toxicity
References
- Thigpen JT, Brady MF, Alvarez RD, Adelson MD, Homesley HD, Manetta A, Soper JT, Given FT. Oral medroxyprogesterone acetate in the treatment of advanced or recurrent endometrial carcinoma: a dose-response study by the Gynecologic Oncology Group. J Clin Oncol. 1999 Jun;17(6):1736-44. link to original article contains verified protocol PubMed
Medroxyprogesterone acetate & Tamoxifen
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Regimen
Study | Evidence |
Whitney et al. 2004 | Phase II |
Endocrine therapy
- Medroxyprogesterone acetate (MPA) 100 mg PO BID on even-numbered weeks (for example, week 2, 4, 6, etc.)
- Tamoxifen (Nolvadex) 20 mg PO BID
Given until progression of disease or unacceptable toxicity
References
- Whitney CW, Brunetto VL, Zaino RJ, Lentz SS, Sorosky J, Armstrong DK, Lee RB; Gynecologic Oncology Group study. Phase II study of medroxyprogesterone acetate plus tamoxifen in advanced endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2004 Jan;92(1):4-9. link to original article contains verified protocol PubMed
Megestrol acetate (Megace)
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Regimen
Study | Evidence | Comparator |
Pandya et al. 2001 (E4882) | Randomized Phase II | Megestrol acetate & Tamoxifen |
Endocrine therapy
- Megestrol acetate (Megace) 80 mg PO BID
Given until progression of disease or unacceptable toxicity
References
- Pandya KJ, Yeap BY, Weiner LM, Krook JE, Erban JK, Schinella RA, Davis TE. Megestrol and tamoxifen in patients with advanced endometrial cancer: an Eastern Cooperative Oncology Group Study (E4882). Am J Clin Oncol. 2001 Feb;24(1):43-6. link to original article contains verified protocol PubMed
Megestrol acetate & Tamoxifen
back to top |
Regimen
Study | Evidence | Comparator |
Pandya et al. 2001 (E4882) | Randomized Phase II | Megestrol acetate |
Endocrine therapy
- Megestrol acetate (Megace) 80 mg PO BID x 3 weeks, alternating with tamoxifen
- Tamoxifen (Nolvadex) 20 mg PO BID x 3 weeks, alternating with megestrol
3-week courses of Megestrol acetate (Megace), alternating back and forth with 3-week courses of Tamoxifen (Nolvadex); given until progression of disease or unacceptable toxicity
References
- Pandya KJ, Yeap BY, Weiner LM, Krook JE, Erban JK, Schinella RA, Davis TE. Megestrol and tamoxifen in patients with advanced endometrial cancer: an Eastern Cooperative Oncology Group Study (E4882). Am J Clin Oncol. 2001 Feb;24(1):43-6. link to original article contains verified protocol PubMed
- Fiorica JV, Brunetto VL, Hanjani P, Lentz SS, Mannel R, Andersen W; Gynecologic Oncology Group study. Phase II trial of alternating courses of megestrol acetate and tamoxifen in advanced endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2004 Jan;92(1):10-4. link to original article contains verified protocol PubMed
Tamoxifen (Nolvadex)
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Regimen
Study | Evidence |
Quinn et al. 1989 | Phase II |
Thigpen et al. 2001 | Phase II |
Endocrine therapy
- Tamoxifen (Nolvadex) 20 mg PO BID
Given until progression of disease or unacceptable toxicity
References
- Quinn MA, Campbell JJ. Tamoxifen therapy in advanced/recurrent endometrial carcinoma. Gynecol Oncol. 1989 Jan;32(1):1-3. link to SD article PubMed
- Thigpen T, Brady MF, Homesley HD, Soper JT, Bell J. Tamoxifen in the treatment of advanced or recurrent endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol. 2001 Jan 15;19(2):364-7. link to original article contains verified protocol PubMed
Adjuvant radiation & chemotherapy
RT -> Cisplatin & Doxorubicin
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RT: Radiation Therapy
Regimen
Study | Evidence | Comparator |
Homesley et al. 2008 (GOG 184) | Phase III | Cisplatin, Doxorubicin, Paclitaxel, RT |
Note: for chemotherapy, body surface area capped at 2.0 m2. Radiation is to begin within 8 weeks after surgery.
Radiotherapy
- Radiation therapy to the pelvis, 1.8 Gy x 28 fractions (total dose: 50.4 Gy)
- Patients with positive para-aortic lymph nodes received 1.5 to 1.8 Gy x 24 to 29 fractions (total dose: 43.5 Gy)
6-week course, followed within 8 weeks by:
Chemotherapy
- Cisplatin (Platinol) 50 mg/m2 IV once on day 1, given second
- Doxorubicin (Adriamycin) 45 mg/m2 IV once on day 1, given first
Supportive medications
- G-CSF, either of the following:
- Filgrastim (Neupogen) 5 mcg/kg SC once per day on days 2 to 11, or until ANC increases to 10,000
- Pegfilgrastim (Neulasta) 6 mg SC once on day 2
- Dexamethasone (Decadron) 10 mg IV once prior to chemotherapy
- 5-HT3 antagonist
21-day cycle for 6 cycles
References
- Homesley HD, Filiaci V, Gibbons SK, Long HJ, Cella D, Spirtos NM, Morris RT, DeGeest K, Lee R, Montag A. A randomized phase III trial in advanced endometrial carcinoma of surgery and volume directed radiation followed by cisplatin and doxorubicin with or without paclitaxel: A Gynecologic Oncology Group study. Gynecol Oncol. 2009 Mar;112(3):543-52. Epub 2008 Dec 23. link to original article link to PMC article contains verified protocol PubMed
RT -> Cisplatin, Doxorubicin, Paclitaxel
back to top |
RT: Radiation Therapy
Regimen
Study | Evidence | Comparator |
Homesley et al. 2008 (GOG 184) | Phase III | Cisplatin, Doxorubicin, RT |
Note: for chemotherapy, body surface area capped at 2.0 m2. Radiation is to start within 8 weeks after surgery.
Radiotherapy
- Radiation therapy to the pelvis, 1.8 Gy x 28 fractions (total dose: 50.4 Gy)
- Patients with positive para-aortic lymph nodes received 1.5 to 1.8 Gy x 24 to 29 fractions (total dose: 43.5 Gy)
6-week course, followed within 8 weeks by:
Chemotherapy
- Cisplatin (Platinol) 50 mg/m2 IV once on day 1, given second
- Doxorubicin (Adriamycin) 45 mg/m2 IV once on day 1, given first
- Paclitaxel (Taxol) 160 mg/m2 IV over 3 hours once on day 2
Supportive medications
- Filgrastim (Neupogen) 5 mcg/kg SC once per day on days 3 to 12, or until ANC increases to 10,000
- Dexamethasone (Decadron) 10 mg IV once prior to day 1 chemotherapy; Dexamethasone (Decadron) 20 mg once 5 to 12 hours prior to paclitaxel on day 2
- 5-HT3 antagonist
21-day cycle for 6 cycles
References
- Homesley HD, Filiaci V, Gibbons SK, Long HJ, Cella D, Spirtos NM, Morris RT, DeGeest K, Lee R, Montag A. A randomized phase III trial in advanced endometrial carcinoma of surgery and volume directed radiation followed by cisplatin and doxorubicin with or without paclitaxel: A Gynecologic Oncology Group study. Gynecol Oncol. 2009 Mar;112(3):543-52. Epub 2008 Dec 23. link to original article link to PMC article contains verified protocol PubMed
Advanced, recurrent, or metastatic disease
Bevacizumab (Avastin)
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Regimen
Study | Evidence |
Aghajanian et al. 2011 | Phase II |
Chemotherapy
- Bevacizumab (Avastin) 15 mg/kg IV once on day 1
21-day cycles, given until progression of disease or unacceptable toxicity
References
- Aghajanian C, Sill MW, Darcy KM, Greer B, McMeekin DS, Rose PG, Rotmensch J, Barnes MN, Hanjani P, Leslie KK. Phase II trial of bevacizumab in recurrent or persistent endometrial cancer: a Gynecologic Oncology Group study. J Clin Oncol. 2011 Jun 1;29(16):2259-65. Epub 2011 May 2. link to original article contains verified protocol PubMed
Carboplatin (Paraplatin)
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Regimen
Study | Evidence |
van Wijk et al. 2003 | Phase II |
Chemotherapy
- Carboplatin (Paraplatin) 400 mg/m2 IV over 30 minutes once on day 1
- Dosage for patients with previously treated with chemotherapy is Carboplatin (Paraplatin) 300 mg/m2 IV over 30 minutes once on day 1
28-day cycles
References
- van Wijk FH, Lhommé C, Bolis G, Scotto di Palumbo V, Tumolo S, Nooij M, de Oliveira CF, Vermorken JB; European Organization for Research and Treatment of Cancer. Gynaecological Cancer Group. Phase II study of carboplatin in patients with advanced or recurrent endometrial carcinoma. A trial of the EORTC Gynaecological Cancer Group. Eur J Cancer. 2003 Jan;39(1):78-85. link to original article contains verified protocol PubMed
Carboplatin & Doxorubicin liposomal
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Regimen
Study | Evidence |
Pignata et al. 2007 (END-1) | Phase II |
Chemotherapy
- Carboplatin (Paraplatin) AUC 5 IV over 30 minutes once on day 1, given first
- Doxorubicin liposomal (Doxil) 40 mg/m2 IV over 60 minutes once on day 1, given second
Supportive medications
- "No prophylactic use of G-CSF was recommended. In case of grade 4 neutropaenia, even without fever, therapeutic and prophylactic use of G-CSF was allowed."
28-day cycle for 3 to 6 cycles
All patients received 3 cycles of therapy. If there was no unacceptable toxicity, patients with stable or responsive disease received an additional 3 cycles.
References
- Pignata S, Scambia G, Pisano C, Breda E, Di Maio M, Greggi S, Ferrandina G, Lorusso D, Zagonel V, Febbraro A, Riva N, De Rosa V, Gallo C, Perrone F; Multicentre Italian Trials in Ovarian Cancer and Gynecologic Malignancies Group. A multicentre phase II study of carboplatin plus pegylated liposomal doxorubicin as first-line chemotherapy for patients with advanced or recurrent endometrial carcinoma: the END-1 study of the MITO (Multicentre Italian Trials in Ovarian Cancer and Gynecologic Malignancies) group. Br J Cancer. 2007 Jun 4;96(11):1639-43. Epub 2007 May 8. link to PMC article contains verified protocol PubMed
Carboplatin & Paclitaxel
back to top |
Regimen #1
Study | Evidence |
Pectasides et al. 2008 | Phase II |
Chemotherapy
- Carboplatin (Paraplatin) AUC 5 IV over 1 hour once on day 1, given second
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1, given first
21-day cycle for 6 to 9 cycles
Regimen #2
Study | Evidence |
Hoskins et al. 2001 | Phase II |
Chemotherapy
- Carboplatin (Paraplatin) AUC 5 to 7 IV once on day 1, given second
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1, given first
21-day cycles
Regimen #3
Study | Evidence |
Sorbe et al. 2008 | Phase II |
Chemotherapy
- Carboplatin (Paraplatin) AUC 5 IV over 1 hour once on day 1
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
21-day cycles
References
- Hoskins PJ, Swenerton KD, Pike JA, Wong F, Lim P, Acquino-Parsons C, Lee N. Paclitaxel and carboplatin, alone or with irradiation, in advanced or recurrent endometrial cancer: a phase II study. J Clin Oncol. 2001 Oct 15;19(20):4048-53. link to original article contains verified protocol PubMed
- Pectasides D, Xiros N, Papaxoinis G, Pectasides E, Sykiotis C, Koumarianou A, Psyrri A, Gaglia A, Kassanos D, Gouveris P, Panayiotidis J, Fountzilas G, Economopoulos T. Carboplatin and paclitaxel in advanced or metastatic endometrial cancer. Gynecol Oncol. 2008 May;109(2):250-4. Epub 2008 Mar 4. link to original article contains verified protocol PubMed content property of HemOnc.org
- Sorbe B, Andersson H, Boman K, Rosenberg P, Kalling M. Treatment of primary advanced and recurrent endometrial carcinoma with a combination of carboplatin and paclitaxel-long-term follow-up. Int J Gynecol Cancer. 2008 Jul-Aug;18(4):803-8. Epub 2007 Oct 18. link to original article contains verified protocol PubMed
- Retrospective: Shechter-Maor G, Bruchim I, Ben-Harim Z, Altaras M, Fishman A. Combined chemotherapy regimen of carboplatin and paclitaxel as adjuvant treatment for papillary serous and clear cell endometrial cancer. Int J Gynecol Cancer. 2009 May;19(4):662-4. link to original article PubMed
Cisplatin & Doxorubicin
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Regimen #1
Study | Evidence | Comparator |
Fleming et al. 2004 (GOG 177) | Phase III | Cisplatin, Doxorubicin, Paclitaxel |
Note: body surface area capped at 2.0 m2.
Chemotherapy
- Cisplatin (Platinol) 50 mg/m2 IV over 1 hour once on day 1, given second
- Doxorubicin (Adriamycin) 60 mg/m2 IV once on day 1, given first
- Dosage for patients with previous pelvic radiation or who were >65 years old is Doxorubicin (Adriamycin) 45 mg/m2 IV once on day 1
21-day cycle for 7 cycles
Regimen #2
Study | Evidence | Comparator |
Randall et al. 2006 (GOG 122) | Phase III | Whole abdominal irradiation |
Chemotherapy
- Cisplatin (Platinol) 50 mg/m2 IV once on day 1 of cycles 1 to 8
- Doxorubicin (Adriamycin) 60 mg/m2 IV once on day 1 of cycles 1 to 7
Supportive hydration:
- Normal saline at 500 mL/H for 2 hours prior to and after cisplatin
21-day cycle for 8 cycles
References
- Fleming GF, Brunetto VL, Cella D, Look KY, Reid GC, Munkarah AR, Kline R, Burger RA, Goodman A, Burks RT. Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2004 Jun 1;22(11):2159-66. link to original article contains verified protocol PubMed
- Randall ME, Filiaci VL, Muss H, Spirtos NM, Mannel RS, Fowler J, Thigpen JT, Benda JA; Gynecologic Oncology Group Study. Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2006 Jan 1;24(1):36-44. Epub 2005 Dec 5. link to original article contains verified protocol PubMed
Cisplatin, Doxorubicin, Paclitaxel
back to top |
Regimen
Study | Evidence | Comparator |
Fleming et al. 2004 (GOG 177) | Phase III | Cisplatin & Doxorubicin |
Note: body surface area capped at 2.0 m2.
Chemotherapy
- Cisplatin (Platinol) 50 mg/m2 IV over 1 hour once on day 1, given second
- Doxorubicin (Adriamycin) 45 mg/m2 IV once on day 1, given first
- Paclitaxel (Taxol) 160 mg/m2 IV over 3 hours once on day 2
Supportive medications
- Filgrastim (Neupogen) 5 mcg/kg SC once per day on days 3 to 12
21-day cycle for 7 cycles
References
- Fleming GF, Brunetto VL, Cella D, Look KY, Reid GC, Munkarah AR, Kline R, Burger RA, Goodman A, Burks RT. Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2004 Jun 1;22(11):2159-66. link to original article contains verified protocol PubMed
Cisplatin, Ifosfamide, Mesna (CIM)
back to top |
CIM: Cisplatin, Ifosfamide, Mesna
Regimen
Study | Evidence | Comparator |
Wolfson et al. 2007 (GOG 150) | Phase III | Whole abdominal irradiation |
Chemotherapy
- Cisplatin (Platinol) 20 mg/m2 IV at an infusion rate of approximately 1 mg/min once per day on days 1 to 4, given first
- Ifosfamide (Ifex) 1500 mg/m2 IV over 1 hour once per day on days 1 to 4, given second together with Mesna (Mesnex)
Supportive medications
- Mesna (Mesnex) 120 mg/m2 IV bolus over 15 minutes once on day 1, then 1500 mg/m2/day IV continuous infusion over 96 hours on days 1 to 4, given second together with Ifosfamide (Ifex)
- Suggested hydration: 1 liter of NS or 1/2 NS given over several hours prior to chemotherapy
21-day cycle for 3 cycles
References
- Wolfson AH, Brady MF, Rocereto T, Mannel RS, Lee YC, Futoran RJ, Cohn DE, Ioffe OB. A gynecologic oncology group randomized phase III trial of whole abdominal irradiation (WAI) vs. cisplatin-ifosfamide and mesna (CIM) as post-surgical therapy in stage I-IV carcinosarcoma (CS) of the uterus. Gynecol Oncol. 2007 Nov;107(2):177-85. Epub 2007 Sep 5. link to PMC article contains verified protocol PubMed
Cisplatin & Paclitaxel
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Regimen
Study | Evidence |
Dimopoulos et al. 2000 | Phase II |
Chemotherapy
- Cisplatin (Platinol) 75 mg/m2 IV over 2 hours once on day 1, given second
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1, given first
Supportive medications
- Dexamethasone (Decadron) 20 mg PO/IV given twice, 12 and 6 hours prior to Paclitaxel (Taxol)
- Diphenhydramine (Benadryl) 25 mg IV once 30 minutes prior to Paclitaxel (Taxol)
- Ranitidine (Zantac) 50 mg IV once 30 minutes prior to Paclitaxel (Taxol)
- 900 mL normal saline mixed with 100 mL mannitol given over 1 hour prior to Cisplatin (Platinol)
- 2 liters NS with potassium & magnesium after Cisplatin (Platinol)
- "Appropriate antiemetics"
- Filgrastim (Neupogen) 5 mcg/kg SC once per day, starting on day 5 and continuing until WBC >10,000
21-day cycle for up to 6 cycles
References
- Dimopoulos MA, Papadimitriou CA, Georgoulias V, Moulopoulos LA, Aravantinos G, Gika D, Karpathios S, Stamatelopoulos S. Paclitaxel and cisplatin in advanced or recurrent carcinoma of the endometrium: long-term results of a phase II multicenter study. Gynecol Oncol. 2000 Jul;78(1):52-7. link to original article contains verified protocol PubMed
Dactinomycin (Cosmegen)
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Regimen
Study | Evidence |
Moore et al. 1999 | Phase II |
Chemotherapy
- Dactinomycin (Cosmegen) 2 mg/m2 IV over 15 minutes once on day 1
28-day cycles
References
- Moore DH, Blessing JA, Dunton C, Buller RE, Reid GC. Dactinomycin in the treatment of recurrent or persistent endometrial carcinoma: A Phase II study of the Gynecologic Oncology Group. Gynecol Oncol. 1999 Dec;75(3):473-5. link to original article contains verified protocol PubMed
Ifosfamide
back to top |
Regimen
Study | Evidence | Comparator |
Homesley et al. 2007 (GOG 161) | Phase III | Ifosfamide & Paclitaxel |
Note: GOG 161 specifies that PO Mesna (Mesnex) is to be taken in 3 divided doses, but only lists 2 time points for its use. The timing of the middle dose is estimated based on other references.
Chemotherapy
- Ifosfamide (Ifex) 1600 mg/m2 IV once per day on days 1 to 3
- Dosage for patients with previous radiation is Ifosfamide (Ifex) 1200 mg/m2 IV once per day on days 1 to 3
Supportive medications
- Mesna (Mesnex) 2000 mg IV over 12 hours once per day on days 1 to 3, starting 15 minutes before Ifosfamide (Ifex)
- Alternate PO dosing: Mesna (Mesnex) 1330 mg PO taken three times per day, 1 hour before, 4 hours after, and 8 hours after Ifosfamide (Ifex) (4000 mg total dose per day), on days 1 to 3
- Filgrastim (Neupogen) 5 mcg/kg SC once per day starting on day 4, to continue until ANC is greater than or equal to 2000
21-day cycle for 8 cycles
References
- Homesley HD, Filiaci V, Markman M, Bitterman P, Eaton L, Kilgore LC, Monk BJ, Ueland FR; Gynecologic Oncology Group. Phase III trial of ifosfamide with or without paclitaxel in advanced uterine carcinosarcoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2007 Feb 10;25(5):526-31. link to original article contains verified protocol PubMed
Ifosfamide & Paclitaxel
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Regimen
Study | Evidence | Comparator |
Homesley et al. 2007 (GOG 161) | Phase III | Ifosfamide |
Note: GOG 161 specifies that PO Mesna (Mesnex) is to be taken in 3 divided doses, but only lists 2 time points for its use. The timing of the middle dose is estimated based on other references.
Chemotherapy
- Ifosfamide (Ifex) 1600 mg/m2 IV once per day on days 1 to 3
- Dosage for patients with previous radiation is Ifosfamide (Ifex) 1200 mg/m2 IV once per day on days 1 to 3
- Paclitaxel (Taxol) 135 mg/m2 IV over 3 hours once on day 1
Supportive medications
- Mesna (Mesnex) 2000 mg IV over 12 hours once per day on days 1 to 3, starting 15 minutes before Ifosfamide (Ifex)
- Alternate PO dosing: Mesna (Mesnex) 1330 mg PO taken three times per day, 1 hour before, 4 hours after, and 8 hours after Ifosfamide (Ifex) (4000 mg total dose per day), on days 1 to 3
- Filgrastim (Neupogen) 5 mcg/kg SC once per day starting on day 4, to continue until ANC is greater than or equal to 2000
- Dexamethasone (Decadron) 20 mg PO/IV given twice, 12 and 6 hours prior to Paclitaxel (Taxol)
- Diphenhydramine (Benadryl) 50 mg IV once 30 minutes prior to Paclitaxel (Taxol)
- Cimetidine (Tagamet) 300 mg IV or Ranitidine (Zantac) 50 mg IV once 30 minutes prior to Paclitaxel (Taxol)
21-day cycle for 8 cycles
References
- Homesley HD, Filiaci V, Markman M, Bitterman P, Eaton L, Kilgore LC, Monk BJ, Ueland FR; Gynecologic Oncology Group. Phase III trial of ifosfamide with or without paclitaxel in advanced uterine carcinosarcoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2007 Feb 10;25(5):526-31. link to original article contains verified protocol PubMed
Paclitaxel (Taxol)
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Regimen #1
Study | Evidence |
Lincoln et al. 2003 | Phase II |
Chemotherapy
- Paclitaxel (Taxol) 200 mg/m2 IV over 3 hours once on day 1
- Dosage for patients with previous pelvic radiation is Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
- Dose of Paclitaxel (Taxol) can be changed to 135 or 110 mg/m2 depending on toxicity
Supportive medications
- Dexamethasone (Decadron) 20 mg PO/IV given twice, 12 and 6 hours prior to paclitaxel
- Diphenhydramine (Benadryl) 50 mg PO/IV once 30 minutes prior to paclitaxel
- Cimetidine (Tagamet) 300 mg IV once 30 minutes prior to paclitaxel
21-day cycles
Regimen #2
Study | Evidence |
Lissoni et al. 1996 | Phase II |
Chemotherapy
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
Supportive medications
- Hydrocortisone (Cortef) 250 mg IV once 1 hour prior to paclitaxel
- Chlorphenamine/chlorpheniramine (H1 blocker) 10 mg IM once 1 hour prior to paclitaxel
- Cimetidine (Tagamet) 300 mg IV once 1 hour prior to paclitaxel
21-day cycles
Regimen #3
Study | Evidence |
Ball et al. 1996 | Phase II |
Chemotherapy
- Paclitaxel (Taxol) 250 mg/m2 IV continuous infusion over 24 hours once on day 1
- Dosage for patients with previous pelvic radiation is 200 mg/m2 IV continuous infusion over 24 hours once on day 1
- Dose can be changed to 200, 170, 135, 110 mg/m2 depending on toxicity
Supportive medications
- Dexamethasone (Decadron) 20 mg PO/IV given twice, 12 and 6 hours prior to paclitaxel
- Diphenhydramine (Benadryl) 50 mg PO/IV once 30 minutes prior to paclitaxel
- Cimetidine (Tagamet) 300 mg IV once 30 minutes prior to paclitaxel
- Filgrastim (Neupogen) 5 mcg/kg SC once per day starting on day 3, 24 hours after chemotherapy, continued for at least 12 days or until two successive total leukocyte counts are 10,000 or greater, whichever comes last
21-day cycles
References
- Ball HG, Blessing JA, Lentz SS, Mutch DG. A phase II trial of paclitaxel in patients with advanced or recurrent adenocarcinoma of the endometrium: a Gynecologic Oncology Group study. Gynecol Oncol. 1996 Aug;62(2):278-81. link to original article contains verified protocol PubMed
- Lissoni A, Zanetta G, Losa G, Gabriele A, Parma G, Mangioni C. Phase II study of paclitaxel as salvage treatment in advanced endometrial cancer. Ann Oncol. 1996 Oct;7(8):861-3. link to original article contains verified protocol PubMed
- Lincoln S, Blessing JA, Lee RB, Rocereto TF. Activity of paclitaxel as second-line chemotherapy in endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2003 Mar;88(3):277-81. link to original article contains verified protocol PubMed
Temsirolimus (Torisel)
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Regimen
Study | Evidence |
Oza et al. 2011 | Phase II |
Chemotherapy
- Temsirolimus (Torisel) 25 mg IV over 30 minutes once per day on days 1, 8, 15, 22
28-day cycles, given until progression of disease, unacceptable toxicity, or patient decision
References
- Oza AM, Elit L, Tsao MS, Kamel-Reid S, Biagi J, Provencher DM, Gotlieb WH, Hoskins PJ, Ghatage P, Tonkin KS, Mackay HJ, Mazurka J, Sederias J, Ivy P, Dancey JE, Eisenhauer EA. Phase II study of temsirolimus in women with recurrent or metastatic endometrial cancer: a trial of the NCIC Clinical Trials Group. J Clin Oncol. 2011 Aug 20;29(24):3278-85. Epub 2011 Jul 25. link to original article contains verified protocol PubMed
Topotecan (Hycamtin)
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Regimen
Study | Evidence |
Wadler et al. 2003 (ECOG E3E93) | Phase II |
Chemotherapy
- Topotecan (Hycamtin) 1.5 mg/m2 IV once per day on days 1 to 5
- Dosage for patients with previous pelvic radiation is 1.2 mg/m2, which can be increased to the 1.5 mg/m2 dose in later cycles if there are no toxicities higher than grade 1
21-day cycles
References
- Wadler S, Levy DE, Lincoln ST, Soori GS, Schink JC, Goldberg G. Topotecan is an active agent in the first-line treatment of metastatic or recurrent endometrial carcinoma: Eastern Cooperative Oncology Group Study E3E93. J Clin Oncol. 2003 Jun 1;21(11):2110-4. link to original article contains verified protocol PubMed
Whole abdominal radiation (WAI)
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Regimen
Study | Evidence | Comparator |
Randall et al. 2006 (GOG 122) | Phase III | Cisplatin & Doxorubicin |
Wolfson et al. 2007 (GOG 150) | Phase III | CIM |
Not commonly used but was a comparator arm; here for reference purposes only.
References
- Randall ME, Filiaci VL, Muss H, Spirtos NM, Mannel RS, Fowler J, Thigpen JT, Benda JA; Gynecologic Oncology Group Study. Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2006 Jan 1;24(1):36-44. Epub 2005 Dec 5. link to original article contains verified protocol PubMed
- Wolfson AH, Brady MF, Rocereto T, Mannel RS, Lee YC, Futoran RJ, Cohn DE, Ioffe OB. A gynecologic oncology group randomized phase III trial of whole abdominal irradiation (WAI) vs. cisplatin-ifosfamide and mesna (CIM) as post-surgical therapy in stage I-IV carcinosarcoma (CS) of the uterus. Gynecol Oncol. 2007 Nov;107(2):177-85. Epub 2007 Sep 5. link to PMC article contains verified protocol PubMed