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Sequential Combination Of Paclitaxel-Carboplatin And Paclitaxel-Liposomal Doxorubicin As A First-Line Treatment In Patients With Ovarian Cancer

A. Potamianou, N. Androulakis, P. Papakotoulas, H. Toufexi, C. Latoufis, C. Kouroussis, C. Christofilakis, N. Xenidis, V. Georgoulias, A. Polyzos
Published 2005 · Medicine

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Cisplatin or carboplatin plus paclitaxel is considered the standard first-line treatment in ovarian cancer. Attempts to maximize tumor cytoreduction with first-line chemotherapy by incorporating new promising agents led to sequential drug administration with two or three doublets. In the present study, we aimed to evaluate the activity and the tolerance of two sequential doublets (paclitaxel/carboplatin and liposomal doxorubicin/carboplatin) administered as first-line treatment in patients with FIGO III/IV ovarian cancer. Treatment consisted of four cycles of carboplatin (6 AUC) plus paclitaxel (175 mg/m2; PC regimen) followed by four cycles with carboplatin (6 AUC) plus liposomal doxorubicin (40 mg/m2; LD/C regimen) every 3 weeks. Forty-one patients in FIGO III or IV were enrolled. In an intention-to-treat analysis, 20 (49%) complete (CR) and 12 (29%) partial (PR) responses were achieved (overall response rate, ORR: 78%; 95% confidence interval, CI: 64.1–91.9%); with the PC regimen (164 cycles); 7 (17%) patients have stable (SD) and 2 (5%) progressive (PD) disease. The LD/C regimen (124 cycles) was administered in 36 (88%) patients because of 2 early deaths and 3 patient withdrawals. Three additional patients, 2 with PR and 1 with SD after PC chemotherapy) achieved a CR. Upon completion of the LD/C chemotherapy there were 18 (44%) patients with CR and 9 (22%) with PR (ORR = 66%; 95% CI: 64–92%). The median duration of response was 27 months and the median time to progression 20 months. The probability of 2-year survival was 67%. Grade 3 and 4 neutropenia was observed in 34 and 14.6% of the patients, respectively, during the PC regimen, while during the treatment with LD/C the percentages for grade 3 and 4 neutropenia were 44.4 and 19.4%, respectively. Febrile neutropenia occurred only in patients treated with the PC regimen (4.9%). The incorporation of liposomal doxorubicin in this sequential doublet schedule of first-line treatment of ovarian carcinoma created a feasible and active regimen. Prospective randomized studies are required to assess its efficacy on patient survival.
This paper references
Pegylated liposomal doxorubicin ( doxil ) : Reduced clinical cardiotoxicity in patients reaching or exceeding cumulative doses of 500 mg / m 2
iT. Safra (2005)
Long - term follow - up confi rms a survival advantage of the paclitaxel - cisplatin ( TP ) regimen over the cyclophosphamide - cisplatin ( CP ) combination in advanced ovarian cancer ( AOC )
JP Neijt (2002)
SEER Cancer Statistics Review , 1973 – 1999
A DuBois
10.1006/GYNO.2000.5921
Phase 2 trial of liposomal doxorubicin (40 mg/m(2)) in platinum/paclitaxel-refractory ovarian and fallopian tube cancers and primary carcinoma of the peritoneum.
M. Markman (2000)
10.1111/J.1525-1438.2003.13357.X
Long‐term follow‐up confirms a survival advantage of the paclitaxel–cisplatin regimen over the cyclophosphamide–cisplatin combination in advanced ovarian cancer
M. Piccart (2003)
10.1016/S0090-8258(03)00496-7
A phase II trial of three sequential doublets for the treatment of advanced müllerian malignancies.
U. Matulonis (2003)
23. Treatment of Advanced Ovarian Cancer with Ascites
K. Hirabayashi (1978)
10.1093/ANNONC/MDF647
The impact of chip technology on cancer medicine.
M. Fey (2002)
10.1016/S0090-8258(03)00337-8
Clinical trials of newer regimens for treating ovarian cancer: the rationale for Gynecologic Oncology Group Protocol GOG 182-ICON5.
L. Copeland (2003)
10.1200/JCO.2000.18.17.3084
Exploratory phase III study of paclitaxel and cisplatin versus paclitaxel and carboplatin in advanced ovarian cancer.
J. Neijt (2000)
10.1200/JCO.2003.02.153
Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: a Gynecologic Oncology Group study.
R. Ozols (2003)
A phase I dose - fi nding study of carboplatin ( C ) paclitaxel ( P ) and liposomal doxorubicin ( LD ) in advanced epithelial ovarian carcinoma ( EOC ) ( abstract 1539 )
AB Miller (2000)
10.1056/nejm199604183341622
CYCLOPHOSPHAMIDE AND CISPLATIN COMPARED WITH PACLITAXEL AND CISPLATIN IN PATIENTS WITH STAGE III AND STAGE IV OVARIAN CANCER
Illiam (2000)
10.1200/JCO.2000.18.24.4038
Phase II feasibility study of sequential couplets of Cisplatin/Topotecan followed by paclitaxel/cisplatin as primary treatment for advanced epithelial ovarian cancer: a National Cancer Institute of Canada Clinical Trials Group Study.
P. Hoskins (2000)
10.1023/A:1008365716693
Pegylated liposomal doxorubicin (doxil): reduced clinical cardiotoxicity in patients reaching or exceeding cumulative doses of 500 mg/m2.
T. Safra (2000)
10.1016/0197-2456(89)90015-9
Optimal two-stage designs for phase II clinical trials.
R. Simon (1989)
Long-term follow-up confirms a survival advantage of paclitaxel-cisplatin (CP) regimen over the cyclophosphamide-cisplatin (CP) combination in advanced ovarian cancer
M. Piccart (2002)
10.1006/GYNO.2001.6581
Phase I study of alternating doublets of topotecan/carboplatin and paclitaxel/carboplatin in patients with newly diagnosed, advanced ovarian cancer.
A. Gordon (2002)
Phase II study of liposomal doxorubicin in refractory ovarian cancer : antitumor activity and toxicity modifi cation by liposomal encapsulation
M Markman (1997)
10.1200/JCO.1997.15.3.987
Phase II study of liposomal doxorubicin in refractory ovarian cancer: antitumor activity and toxicity modification by liposomal encapsulation.
F. Muggia (1997)
ploratory phase III study of paclitaxel and cisplatin versus paclitaxel and carboplatin in advanced ovarian cancer
RF Ozols (2000)
10.1002/1097-0142(19810101)47:1<207::AID-CNCR2820470134>3.0.CO;2-6
Reporting results of cancer treatment
A. Miller (1981)
10.1016/S0140-6736(96)06071-0
Epithelial ovarian carcinoma
G. Kristensen (1997)
10.1200/JCO.2001.19.14.3312
Recurrent epithelial ovarian carcinoma: a randomized phase III study of pegylated liposomal doxorubicin versus topotecan.
A. Gordon (2001)
10.1016/S0140-6736(02)09738-6
Paclitaxel plus carboplatin versus standard chemotherapy with either single-agent carboplatin or cyclophosphamide, doxorubicin, and cisplatin in women with ovarian cancer: The ICON3 randomised trial
M. Parmar (2002)
10.1006/GYNO.1996.0213
A phase I/II study of dose-intense paclitaxel with cisplatin and cyclophosphamide as initial therapy of poor-prognosis advanced-stage epithelial ovarian cancer.
E. Kohn (1996)
Kosary CL, et al: SEER Cancer Statistics Review, 1973–1999
LAG Ries (2002)
10.1200/JCO.2000.18.1.106
Phase III randomized study of cisplatin versus paclitaxel versus cisplatin and paclitaxel in patients with suboptimal stage III or IV ovarian cancer: a gynecologic oncology group study.
F. Muggia (2000)
10.1016/S0140-6736(02)09738-6
Paclitaxel plus carboplatin versus standard chemotherapy with either single-agent carboplatin or cyclophosphamide, doxorubicin, and cisplatin in women with ovarian cancer: the ICON3 randomised trial
The International Collaborative Ovarian Neoplasm Group (2002)
10.1016/S0959-8049(01)00328-8
Treatment of advanced ovarian cancer.
A. Bois (2001)



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