Roshan Prajapati
Bhaktapur Cancer Hospital, Nepal
Title: Nano particle formulation Paclitaxel (Nanoxel) – Alternative to conventional Paclitaxel in the treatment of advanced epithelial ovarian cancer as neo adjuvant chemotherapy
Biography
Biography: Roshan Prajapati
Abstract
Background: Epithelial ovarian cancer (EOC) is the leading cause of death in women with gynecological malignancy.
Approximately 70% of women with EOC are diagnosed with advanced stage of disease, which is associated with high morbidity
and mortality. Currently, standard primary therapy for patients with advanced EOC is primary debulking surgery (PDS)
aiming to remove all visible tumor tissue, followed by adjuvant chemotherapy (ACT) with paclitaxel and carboplatin. EOC
is one of the most sensitive of all solid tumors to cytotoxic drugs, with over 80% of women showing a response to standard
chemotherapy combining taxane and platinum. Due to inadequate screening tools and a lack of early clinical symptoms,
approximately 70% of women with EOC are diagnosed with advanced stage of disease, which is associated with high morbidity
and mortality. Recently, interval debulking surgery (IDS) aft er a short course of neoadjuvant chemotherapy (NACT), usually
three cycles of chemotherapy, has become a possible alternative treatment option to standard treatment in patients unable to
undergo complete resection during PDS.
Objectives: To evaluate the benefi ts and toxicity of nano particle formulation paclitaxel (nanoxel) in advanced ovarian cancer
as neo adjuvant chemotherapeutic agent instead of conventional paclitaxel.
Design: Retrospective descriptive study.
Methods: Th e case records of patient presenting with advanced ovarian cancer stage IIIc to IV who received neo adjuvant
chemotherapy prior interval cytoreductive surgery between 2016 Jan to 2017 Jan at Bhaktapur Cancer Hospital were analyzed.
Demographic and clinical data were reviewed.
Result: Total of 32 patients, received NACT, and all patients received nano paclitaxel and carboplatin based regimen weekly
day 1, day 8 and day 15 every 4 weeks. Out of 32 patients, 15 (46.87%) patients were of high grade serous adenocarcinoma,
5(15.62%) were of mucinous cystadenocarcinoma, and rest of 12 (37.5%) were of other histology. 26 patients were presented
with stage IIIC, 6 patients with stage IV. On the basis of CT scan report and clinical examination, the clinical effi cacy and
toxicities were evaluated, 6(18.75%) obtained complete response to NACT, 24(74%) obtained partial response, and 2(6.25%)
were non-responder to NACT. All the patients who received neo adjuvant nano paclitaxel based chemotherapy were observed
for its toxicity and no any signifi cant results were found.
Conclusion: Nano particle formulation paclitaxel