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Objective: The optimum sequencing of adjuvant treatment in patients with high-risk endometrial cancer remains contentious. Here, we report the outcomes of women treated in Manchester, United Kingdom, where sequential chemotherapy-radiotherapy is the standard adjuvant treatment approach for these patients. Methods: A retrospective analysis was carried out on 106 consecutive patients referred for adjuvant treatment of high-risk endometrial cancer in 2014 and 2015. High-risk endometrial cancer was defined as: International Federation of Gynaecology and Obstetrics (2009) stage I grade 3 endometrioid carcinoma with deep myometrial invasion and/or lymphovascular space invasion, stage II-III endometrioid carcinoma, or any other histological subtype with stage I-III disease. Adjuvant treatment included carboplatin (AUC5) and paclitaxel (175 mg/m2) every 21 days for 4/6 cycles, followed by external beam pelvic radiotherapy (40 Gy in 20 fractions#) or vaginal brachytherapy (28 Gy in 2 fractions#) or both. Primary outcome measures were recurrence free survival (RFS), overall survival (OS) and treatment-related toxicity. Results: Seventy-nine percent of patients were treated with sequential chemotherapy-radiotherapy. After a median follow-up of 64.4 months, 5-year RFS was 70% (95% CI 60.8-80.6%) and 5-year OS was 71.4% (95% CI 62.3-81.7%). Single modality adjuvant therapy was given for patient choice or contra-indications to treatment. Patients tolerated sequential treatment well; 96% of patients completed all treatment and 20% of patients had=grade 3 adverse events. Conclusions: Sequential chemotherapy-radiotherapy as adjuvant treatment for high-risk endometrial cancer was tolerable and was associated with survival outcomes consistent with recent international phase III clinical trials. [ABSTRACT FROM AUTHOR]

Introduction: Standard of care treatment for women who develop relapsed ovarian cancer includes sequential platinum- and/or paclitaxel-based chemotherapy, with reducing disease-free intervals. Once platinum resistance develops, treatment options become limited and dose-dense regimens may be offered. We report the efficacy and safety of dose-dense cisplatin with gemcitabine chemotherapy for relapsed platinum-resistant ovarian cancer. Methods: A retrospective analysis of all patients with relapsed, platinum-resistant ovarian, primary peritoneal or fallopian tube cancer treated with cisplatin 35 mg/m2 of body surface area by intravenous infusion with gemcitabine 1000 mg/m2 of body surface area by intravenous infusion on days 1 and 8 of every 21-day treatment cycle between 1 January 2009 and 1 June 2017. Results: Ninety-four eligible patients had received a median of three (range one–eight) prior lines of cytotoxic therapy for relapsed ovarian cancer. Sixty patients (64%) had received ≥ 1 prior dose-dense chemotherapy regimen. Dose-dense cisplatin with gemcitabine was associated with a median progression-free survival (PFS) of 4.4 months (95% CI 3.6 to 5.3) and overall survival of 7.6 months (95% CI 5.6 to 9.6). The median PFS for dose-dense cisplatin with gemcitabine as first- (n = 34), second- (n = 42), and third-line or later (n = 18) dose-dense therapy was 4.2 (95% CI 3.2 to 5.2), 5.0 (95% CI 3.5 to 6.5), and 4.2 (95% CI 3.3 to 5.1) months respectively. The RECIST objective response rate for first-, second-, and third-line dose-dense cisplatin with gemcitabine was 23%, 14 %, and 7 % respectively. The most common grade 3 – 4 adverse events were thrombocytopenia (20%), anemia (18%), and neutropenia (14%). Discussion: Dose-dense cisplatin with gemcitabine provides modest efficacy whether it is used as a first- or subsequent line of dose-dense chemotherapy to treat relapsed platinum-resistant ovarian cancer and the toxicity is manageable with supportive measures. [ABSTRACT FROM AUTHOR]