autologous blood and marrow transplantation - Blog Science ...

382 Chapter 7: Solid Tumors
Survival
Months
Figure 1. Progression-free and overall survival of patients with platinum resistant ovarian
cancer following an autologous transplant.
four had suboptimal III disease at diagnosis. At a median time from diagnosis of 26
months, 65% are disease-free.
Comparisons to conventional therapy
To date there have been no randomized trials comparing transplant to conven­
tional therapy for patients relapsing after an initial remission. This is largely due to
the fact that there is no curative conventional therapy available for this group.
However, we have performed several comparisons using matched patients from our
patient cohort to defined trials of conventional salvage therapy. 13
' 14
These
comparisons support our conclusions of the benefit of transplant in patients with
relapsed, chemosensitive, low-tumor-burden ovarian cancer. For patients in first
relapse not previously exposed to paclitaxel, this agent administered in conven­
tional doses for platinum-resistant disease gives a 4-month PFS 13
, which is
identical to a matched platinum-resistant group that received transplant. In contrast,
those with platinum-sensitive disease have a 4.5-month PFS with paclitaxel 13
vs. 8
months with transplant. In addition, while all conventionally treated platinum-
sensitive patients had relapsed by 20 months, 30% of the transplants were
progression-free and at 3 years 18% remain progression-free.
A similar analysis was performed for those with sensitive disease whose first
remission lasted more than a year before first salvage therapy was administered.