The safety, efficacy, and treatment outcomes of a combination of low-dose decitabine treatment in patients with recurrent ovarian cancer

Purpose: DNA demethylating agents have shown clinical effectiveness in hematological and solid tumors. This trial tested the safety, efficacy, and treatment outcomes of decitabine-based chemotherapy or combined with immunotherapy in recurrent ovarian cancer patients. Patients and methods: Fifty-five...

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Main Authors: Yan Zhang, Qian Mei, Yang Liu, Xiang Li, Malcolm V. Brock, Meixia Chen, Liang Dong, Lu Shi, Yao Wang, Mingzhou Guo, Jing Nie, Weidong Han
Format: Article
Language:English
Published: Taylor & Francis Group 2017-09-01
Series:OncoImmunology
Subjects:
Online Access:http://dx.doi.org/10.1080/2162402X.2017.1323619
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author Yan Zhang
Qian Mei
Yang Liu
Xiang Li
Malcolm V. Brock
Meixia Chen
Liang Dong
Lu Shi
Yao Wang
Mingzhou Guo
Jing Nie
Weidong Han
author_facet Yan Zhang
Qian Mei
Yang Liu
Xiang Li
Malcolm V. Brock
Meixia Chen
Liang Dong
Lu Shi
Yao Wang
Mingzhou Guo
Jing Nie
Weidong Han
author_sort Yan Zhang
collection DOAJ
description Purpose: DNA demethylating agents have shown clinical effectiveness in hematological and solid tumors. This trial tested the safety, efficacy, and treatment outcomes of decitabine-based chemotherapy or combined with immunotherapy in recurrent ovarian cancer patients. Patients and methods: Fifty-five patients with recurrent ovarian cancer were enrolled and 52 were assessable for clinical response and survival. Patients either received 5-d decitabine treatment, followed by reduced-dose of paclitaxel/carboplatin administration (DTC cohort), or the aforementioned regimen combined with cytokine-induced killer cells therapy (DTC+CIK cohort). The primary end point was clinical response rate and progression-free survival (PFS). Secondary evaluation included safety assessment and overall survival (OS). Results: Disease control rate (DCR) and objective response rate (ORR) were 73.91% and 23.91% in disease measurable patients by RECIST criteria, totally 76.92% and 30.77%, including disease non-measurable patients, which were higher in platinum-resistant/refractory patients. Clinical benefits could be associated with the number of DAC treatment cycles and the inclusion of CIK immunotherapy. In DTC+CIK cohort, DCR and ORR reached 100% and 58.30%, respectively. Notably, DTC+CIK treatment in platinum-resistant/refractory patients had an ORR of 87.50%. Consistently, PFS was longer in platinum-resistant/refractory patients comparing with that of platinum-sensitive patients. PFS and OS were 8 and 19 mo in platinum-resistant/refractory patients with DTC+CIK therapy. The most common toxicities were nausea, anorexia, fatigue, neutropenia, and anemia; many of which were grade 1–2. Conclusion: Low-dose DAC/paclitaxel/carboplatin regimen demonstrates disease benefit, especially in patients with platinum-resistant/refractory ovarian cancer, and might show remarkable clinical response when combined with adoptive immunotherapy in platinum-resistant/refractory ovarian cancer patients.
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spelling doaj.art-1367d299663f488eab12a81b3e181fe42022-12-21T23:19:34ZengTaylor & Francis GroupOncoImmunology2162-402X2017-09-016910.1080/2162402X.2017.13236191323619The safety, efficacy, and treatment outcomes of a combination of low-dose decitabine treatment in patients with recurrent ovarian cancerYan Zhang0Qian Mei1Yang Liu2Xiang Li3Malcolm V. Brock4Meixia Chen5Liang Dong6Lu Shi7Yao Wang8Mingzhou Guo9Jing Nie10Weidong Han11Institute of Basic Medicine, Chinese PLA General HospitalInstitute of Basic Medicine, Chinese PLA General HospitalInstitute of Basic Medicine, Chinese PLA General HospitalInstitute of Basic Medicine, Chinese PLA General HospitalJohns Hopkins UniversityInstitute of Basic Medicine, Chinese PLA General HospitalInstitute of Basic Medicine, Chinese PLA General HospitalInstitute of Basic Medicine, Chinese PLA General HospitalInstitute of Basic Medicine, Chinese PLA General HospitalDepartment of Gastroenterology and Hepatology, Chinese PLA General HospitalInstitute of Basic Medicine, Chinese PLA General HospitalInstitute of Basic Medicine, Chinese PLA General HospitalPurpose: DNA demethylating agents have shown clinical effectiveness in hematological and solid tumors. This trial tested the safety, efficacy, and treatment outcomes of decitabine-based chemotherapy or combined with immunotherapy in recurrent ovarian cancer patients. Patients and methods: Fifty-five patients with recurrent ovarian cancer were enrolled and 52 were assessable for clinical response and survival. Patients either received 5-d decitabine treatment, followed by reduced-dose of paclitaxel/carboplatin administration (DTC cohort), or the aforementioned regimen combined with cytokine-induced killer cells therapy (DTC+CIK cohort). The primary end point was clinical response rate and progression-free survival (PFS). Secondary evaluation included safety assessment and overall survival (OS). Results: Disease control rate (DCR) and objective response rate (ORR) were 73.91% and 23.91% in disease measurable patients by RECIST criteria, totally 76.92% and 30.77%, including disease non-measurable patients, which were higher in platinum-resistant/refractory patients. Clinical benefits could be associated with the number of DAC treatment cycles and the inclusion of CIK immunotherapy. In DTC+CIK cohort, DCR and ORR reached 100% and 58.30%, respectively. Notably, DTC+CIK treatment in platinum-resistant/refractory patients had an ORR of 87.50%. Consistently, PFS was longer in platinum-resistant/refractory patients comparing with that of platinum-sensitive patients. PFS and OS were 8 and 19 mo in platinum-resistant/refractory patients with DTC+CIK therapy. The most common toxicities were nausea, anorexia, fatigue, neutropenia, and anemia; many of which were grade 1–2. Conclusion: Low-dose DAC/paclitaxel/carboplatin regimen demonstrates disease benefit, especially in patients with platinum-resistant/refractory ovarian cancer, and might show remarkable clinical response when combined with adoptive immunotherapy in platinum-resistant/refractory ovarian cancer patients.http://dx.doi.org/10.1080/2162402X.2017.1323619cik therapydecitabineepigenetic therapyplatinum sensitivityrecurrent ovarian cancer
spellingShingle Yan Zhang
Qian Mei
Yang Liu
Xiang Li
Malcolm V. Brock
Meixia Chen
Liang Dong
Lu Shi
Yao Wang
Mingzhou Guo
Jing Nie
Weidong Han
The safety, efficacy, and treatment outcomes of a combination of low-dose decitabine treatment in patients with recurrent ovarian cancer
OncoImmunology
cik therapy
decitabine
epigenetic therapy
platinum sensitivity
recurrent ovarian cancer
title The safety, efficacy, and treatment outcomes of a combination of low-dose decitabine treatment in patients with recurrent ovarian cancer
title_full The safety, efficacy, and treatment outcomes of a combination of low-dose decitabine treatment in patients with recurrent ovarian cancer
title_fullStr The safety, efficacy, and treatment outcomes of a combination of low-dose decitabine treatment in patients with recurrent ovarian cancer
title_full_unstemmed The safety, efficacy, and treatment outcomes of a combination of low-dose decitabine treatment in patients with recurrent ovarian cancer
title_short The safety, efficacy, and treatment outcomes of a combination of low-dose decitabine treatment in patients with recurrent ovarian cancer
title_sort safety efficacy and treatment outcomes of a combination of low dose decitabine treatment in patients with recurrent ovarian cancer
topic cik therapy
decitabine
epigenetic therapy
platinum sensitivity
recurrent ovarian cancer
url http://dx.doi.org/10.1080/2162402X.2017.1323619
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