Management of platinum-sensitive relapsed ovarian cancer, with particular reference to the International Collaboration in Ovarian Neoplasm-4/Arbeitsgemeinschaft Gynakologische Onkologie Ovarian Cancer-2.2 trial.
Abstract
Substantial progress has been made since the early 1990s regarding the treatment of patients with ovarian cancer. Those patients relapsing more than 6 months after platinum-based chemotherapy may benefit from repeat chemotherapy that includes carboplatin. When the treatment-free interval is >12 months, carboplatin combined with paclitaxel (or possibly another agent) is likely to provide a survival advantage compared with carboplatin monotherapy. Evidence to support this comes from the International Collaboration in Ovarian Neoplasm-4/Arbeitsgemeinschaft Gynakologische Onkologie Ovarian Cancer-2.2 trial, a prospective randomized trial of 802 patients designed to assess the potential benefit of combining carboplatin with paclitaxel. One arm of the trial contained patients randomized to conventional platinum-based therapy, while those randomized to the second arm received a paclitaxel-platinum combination. There was a 7% increase in survival for paclitaxel-based treatment (2-year increase from 50% to 57%; P = 0.02) and a 10% increase in progression-free survival (1-year increase from 40% to 50% in favor of paclitaxel-based treatment; P = 0.0004). The major observed differences between the treatment arms in terms of toxicity were significant alopecia (25% versus 86% in arms 1 and 2, respectively), neurotoxicity (1% versus 20%), and hematologic toxicity (46% versus 29%). When the treatment-free interval was between 6 and 12 months, the extent of the benefit was less clear and further trials are certainly warranted.
Collections
Subject
Humans
Ovarian Neoplasms
Neoplasm Recurrence, Local
Cisplatin
Paclitaxel
Carboplatin
Antineoplastic Combined Chemotherapy Protocols
Disease-Free Survival
Survival Analysis
Time Factors
Aged
Middle Aged
Female
Research team
Medicine Drug Development Unit (Kaye)
Language
eng
License start date
2005-05
Citation
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2005, 15 Suppl 1 pp. 31 - 35