Gemcitabine in heavily pretreated patients with recurrent ovarian, peritoneal and fallopian tube carcinoma

Purpose of investigation: To report the experience of a single institution in the south of Israel with gemcitabine in heavily pretreated patients with platinum-resistant recurrent ovarian, peritoneal and fallopian tube carcinoma. Methods: The hospital records of 21 patients with ovarian, peritoneal and fallopian tube carcinoma who had salvage chemotherapy with gemcitabine between October 1998 and November 2003 were retrospectively reviewed. Gemcitabine, 1000 mg/m(2), was given on days 1, 8, and 15 of every 28 days. Dose intensity and relative dose intensity of gemcitabine were calculated. Response was determined using clinical evaluation, radiological reports and CA-125 level. Toxicity was graded using the National Cancer Institute (NCI) criteria. Results: The median relative dose intensity of gemcitabine received by the patients was 0.91, with 17 (81%) patients receiving more than 80% of the planned standard dose intensity. Two (9.5%) patients had complete response of disease lasting for ten and 33 months, respectively, eight (38.1%) had stable disease and 11 (52.4%) had progressive disease. Three (14.3%) patients had CA-125 complete response, five (23.8%) had CA-125 partial response, six (28.5%) had CA-125 stable levels and seven (33.3%) had CA-125 progressive levels. Toxicity was mainly hematological with grade 3-4 toxicity as follows: leukopenia - two (9.5%) patients, neutropenia - four (19%), thrombocytopenia - three (14.3%) and anemia - one (4.7%). Conclusion: Gemcitabine has some activity and low and well tolerated toxicity in heavily pretreated patients with platinum-resistant recurrent ovarian, peritoneal and fallopian tube carcinoma.