Gemcitabine for advanced endometrial cancer: A retrospective study of the Memorial Sloan-Kettering Cancer Center experience Journal Article

Authors: Grisham, R. N.; Adaniel, C.; Hyman, D. M.; Ma, W.; Iasonos, A.; Aghajanian, C.; Konner, J.
Article Title: Gemcitabine for advanced endometrial cancer: A retrospective study of the Memorial Sloan-Kettering Cancer Center experience
Abstract: Background: Gemcitabine is active in several gynecologic malignancies including ovarian cancer, cervical cancer, and uterine leiomyosarcoma. It has been used in an off-label setting for the treatment of advanced endometrial cancer, despite lack of published data showing efficacy. We performed a retrospective study to determine the progression-free survival and response rate of endometrial cancer patients treated with gemcitabine at Memorial Sloan-Kettering Cancer Center. Methods: Eligible patients had histologically confirmed advanced (stage IV or recurrent) endometrial cancer that was treated with single-agent gemcitabine at Memorial SloanKettering Cancer Center between 1999 and 2009. Response to therapy was determined by review of computed tomography imaging by Response Evaluation Criteria in Solid Tumors 1.1 criteria. Results: Forty-six patients were included in the analysis. Median age was 66 years (range, 52Y87 years). All patients were previously treated with chemotherapy. The median number of prior lines of chemotherapy was 2 (range, 1Y8). Median dose of gemcitabine administered was 800 mg/m 2 infused on days 1 and 8 of a 21-day cycle. Predominant histology was endometrioid (48%, n = 22) followed by serous (35%, n = 16), clear cell (15%, n = 7), and undifferentiated (2%, n = 1). Overall response rate was 10.9% (95% confidence interval, 1.9%Y19.9%); 5 patients (11%) achieved a partial response. Thirteen patients (28%) displayed stable disease lasting at least 3 months. Of note, 5 (71%) of the 7 patients with clear cell histology displayed stable disease or partial response (n = 5). The median progression-free survival was 3.0 months (95% confidence interval, 2.1Y3.3 months). Nonhematologic grades 3 and 4 toxicities were rare. Ten patients (22%) were treated with granulocyte colony-stimulating factor during treatment. Grade 3 thrombocytopenia was seen in 4 patients (9%). There were no cases of grade 4 thrombocytopenia. Conclusions: In a mixed population of patients with previously treated advanced endometrial cancer, gemcitabine was well tolerated and showed modest activity. Patients with clear cell histology appeared to have greater likelihood of benefit. © 2012 by IGCS and ESGO.
Keywords: adult; cancer chemotherapy; aged; aged, 80 and over; middle aged; survival rate; retrospective studies; major clinical study; constipation; fatigue; advanced cancer; diarrhea; gemcitabine; cancer patient; cancer radiotherapy; cancer staging; follow-up studies; endometrial cancer; endometrial neoplasms; neoplasm staging; endometrium cancer; edema; progression free survival; computer assisted tomography; multiple cycle treatment; neoplasm recurrence, local; antimetabolites, antineoplastic; bleeding; lung disease; mucosa inflammation; nausea; neuropathy; thrombocytopenia; myalgia; retrospective study; fever; rash; adenocarcinoma, clear cell; cystadenocarcinoma, serous; ca-125 antigen; deoxycytidine; granulocyte colony stimulating factor; advanced endometrial cancer
Journal Title: International Journal of Gynecological Cancer
Volume: 22
Issue: 5
ISSN: 1048-891X
Publisher: Lippincott Williams & Wilkins  
Date Published: 2012-06-01
Start Page: 807
End Page: 811
Language: English
DOI: 10.1097/IGC.0b013e31824a33a2
PROVIDER: scopus
PUBMED: 22635030
PMCID: PMC3904291
Notes: --- - "Export Date: 1 August 2012" - "CODEN: IJGCE" - "Source: Scopus"
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MSK Authors
  1. Jason Konner
    85 Konner
  2. Weining Ma
    20 Ma
  3. Alexia Elia Iasonos
    182 Iasonos
  4. Rachel Nicole Grisham
    36 Grisham
  5. David Hyman
    194 Hyman