Weekly taxol (T) and carboplatin (P) as first-line therapy in advanced ovarian cancer (AOC): a phase II study
Reviewer: Ryan Smith, MD
The Abramson Cancer Center of the University of Pennsylvania
Last Modified: May 18, 2002
Presenter: J. Sehouli Presenter's Affiliation: North-East Society of Gynaecological Oncology (NOGGO), Berlin, Germany Type of Session: Scientific
Ovarian cancer often remains asymptomatic until it progresses to an advanced stage. This causes delay in diagnosis until patients have advanced disease. Therefore, chemotherapy remains an essential aspect of treatment for many patients with this disease. Platinum-containing chemotherapy with paclitaxel is the standard regimen for ovarian cancer. This study evaluates the use of taxol and carboplatin in a weekly regimen.
Materials and Methods
Phase II study based on toxicity data from a phase I study
93 patients, all of whom had preceding surgery
Dosage: Taxol 100 mg/m2, carboplatin AUC 2
Chemotherapy given weekly x 6--14 d break--weekly x 6--28 d break--weekly x 3--14 d break--weekly x 3. Total treatment time of 6 months
Median follow-up of 17 months
72% of patients were FIGO stage III, 26% were stage IV
At start of chemotherapy, 39% were tumor free, 34% had <2cm residual tumor, 27% had >2cm residual tumor
70% had a complete radiologic response
82% of the patients had a decrease in CA-125 of >75%
Median time to progression was 17 months
OAS of 18 months
Toxicity data: 90% experienced alopecia, 19% had >Grade 1 neurotoxicity, 4% had >Grade 1 diarrhea
Weekly schedule of carbotaxol chemotherapy in the treatment of advanced ovarian cancer is both well tolerated and efficacious
Taxol based chemotherapy combined with platinum-based chemotherapy remains the standard for advanced ovarian cancer. Given the fact that the majority of ovarian cancer patients present at an advanced stage of disease, efficacious adjuvant chemotherapy is extremely important in the treatment of this disease. The overall trend is to reduce the interval between chemotherapy infusions in the treatment of many other malignancies (lung, colon, rectal, head and neck, etc.). This study investigates the same type of regimen in ovarian cancer. This is logical in several aspects, most notably that a more continuous steady state of chemotherapy can be maintained in patients, lack of response can lead to a change in therapy with more rapidity, and toxicity from chemotherapy can be accounted for more rapidly with the adjustment of chemotherapy doses with a weekly schedule. Although this is done in a phase II format, and more follow up time is required for the data to mature, the administration of carbotaxol chemotherapy in a weekly schedule seems both well tolerated and successful.
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Mar 16, 2010 - The addition of sorafenib to carboplatin and paclitaxel chemotherapy in patients with advanced non-small-cell lung cancer does not show a clinical benefit supporting use as first-line therapy, according to research published online March 8 in the Journal of Clinical Oncology.