Treosulfan as an effective second-line therapy in ovarian cancer

Despite radical surgery and aggressive platinum-containing chemotherapy, the outcome of patients with ovarian cancer is very poor, Most of them suffer from recurrent or progressive disease. These patients should be treated with an effective second-line therapy showing only few toxic side effects in order not to affect the quality of life. From July 1992 to March 1995, 80 patients with recurrent or progressive ovarian cancer were treated with treosulfan at our department. All of them could be evaluated for toxicity, 72 patients for response to therapy. There were 2 complete and 13 partial responses for an objective response rate of 21%. Among the responding patients, the median survival time was 24.3 months, 32% of patients had stable disease with a median survival of 13.3 months. 34 (47%) non responding patients showed a survival time of 5.4 months, In 43 women with progressive disease within 12 months after primary therapy, a response rate of 21% and a stable disease of 30 could be achieved. Toxic side effects were rare and of moderate intensity. Life-threatening myelosuppression or emesis resistant to therapy, or alopecia, were not observed. We conclude that treosulfan is an effective drug in second-line therapy for patients with recurrent or progressive ovarian cancer, without affecting the quality of life.