A randomized trial of five versus eight courses of cisplatin or carboplatin in advanced epithelial ovarian carcinoma

Abstract

There is insufficient evidence at the present time to justify more than five courses of first-line single agent platinum chemotherapy in the management of advanced ovarian cancer.

A phase II study of sequential carboplatin, paclitaxel and topotecan in patients with previously untreated advanced ovarian cancer

“…Comparison of the survival data from our study with that of a matched population of patients with suboptimally debulked, advanced ovarian cancer, all of whom received between five and eight cycles of carboplatin (Lambert et al, 1993(Lambert et al, , 1997, were identical. Therefore, it is plausible that patients in the current study were not disadvantaged by receiving only two cycles of carboplatin.…”

“…Survival in the study population is compared in these figures with 3 7 2 2 0 0 0 0 1 3 1 1 Mucositis 0 0 0 0 1 2 1 1 0 0 0 0 Diarrhoea 1 2 1 1 0 0 0 0 2 5 2 1 Alopecia 0 0 0 0 15 37 22 28 18 47 72 50 Thromboembolic event 2 5 2 2 1 2 2 3 0 0 0 0 Haematological Anaemia 1 2 1 1 2 5 2 3 6 16 6 4 Neutropenia 2 5 0 0 2 5 3 4 31 82 88 61 Neutropenic sepsis 2 5 2 2 2 5 2 3 5 13 8 6 Thrombocytopenia 1 2 1 1 0 0 1 1 4 11 5 that of a matched group of patients from two previous North Thames ovary trials and found to be similar (Lambert et al, 1993;Lambert et al, 1997). In this group, all patients had inoperable disease or measurable disease 42 cm at the end of surgery and received between five and eight cycles of carboplatin.…”

“…There is also uncertainty in the literature as to the optimum number of treatment cycles (Lambert et al, 1997) and the optimum platinum dose (Ngan et al, 1989;Kaye et al, 1996). With specific regard to carboplatin dose intensity, two trials failed to show any significant survival benefit between patients treated with an areaunder-the-curve (AUC) of 4 or 8 (Jakobsen et al, 1997) or AUC 6 or 12 (Gore et al, 1998).…”

Analysis of 96 patients with advanced ovarian carcinoma treated with high-dose chemotherapy and autologous stem cell transplantation

“…There have been trials comparing shorter vs longer chemotherapy treatments; overall, there is little scientific evidence that prolonging standard induction chemotherapy offers a survival advantage. 19,20 Newer approaches have included IP interferon-alpha, which has shown activity in patients with low volume chemosensitive disease. 21 Clinical trials are underway to determine the role of other therapies, including interleukins and gene therapy.…”

Future directions in the management of ovarian cancer

“…Most patients diagnosed with more advanced stage disease go on to develop disease recurrence. Much interest has focused on the prevention of disease recurrence in ovarian cancer by manipulating initial treatment via different routes of administration of chemotherapy (ie, intraperitoneal [3]), prolonged courses of initial chemotherapy [4,5], or the use of neoadjuvant chemotherapy before optimal initial debulking surgery [6]. Future strategies might entail the use of biologic therapies after standard chemotherapeutic strategies as consolidation or maintenance following primary treatment.…”