Feasibility and response to nedaplatin monotherapy in older patients with ovarian cancer.

PURPOSE: Nedaplatin (NDP), a second-generation platinum analog, has been developed to reduce the toxicity of cisplatin. Although the use of NDP for older patients seems suitable because of the reduced risk of toxicity, few studies have investigated its application to older patients with ovarian cancer (OC). The objective of this study was to compare the tolerability and effectiveness of NDP between patients older and younger than 70 years of age with OC.

METHODS: We enrolled 56 patients with OC who were treated with NDP monotherapy and divided them into those who were 70 years and older (n = 18) and younger than 70 years (n = 38). NDP was administered intravenously until disease progression or unacceptable toxicities occurred.

RESULTS: The incidences of grade 3/4 hematological toxicities were significantly higher in the older patients than in the younger patients, including anemia (p = 0.0021), leucopenia (p = 0.029), neutropenia (p = 0.0048), and thrombocytopenia (p = 0.0024). The incidence of elevated creatinine was also significantly higher in the older patients (p = 0.0063). Older patients had significantly more frequent dose reductions (p = 0.017) and treatment interruptions from toxicity (p = 0.04). The tumor response rate for NDP did not differ significantly between younger (29%) and older (28%) patients (p = 0.47). The two age groups also did not significantly differ in progression-free survival (p = 0.27) and overall survival (p = 0.46).

CONCLUSIONS: Although NDP is a useful therapeutic option for OC, careful consideration of the adverse effect should be given for patients 70 years and older.