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

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Presenter: J. Sehouli
Presenter's Affiliation: North-East Society of Gynaecological Oncology (NOGGO), Berlin, Germany
Type of Session: Scientific

Background

    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

Results

  • 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

Author's Conclusions

  • Weekly schedule of carbotaxol chemotherapy in the treatment of advanced ovarian cancer is both well tolerated and efficacious

Clinical/Scientific Implications

    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.

Oncolink's ASCO Coverage made possible by an unrestricted Educational Grant from Bristol-Myers Squibb Oncology.



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