Survival and Long-Term Toxicity Results in the SCOTROC Study: Docetaxel-Carboplatin (DC) vs. Paclitaxel-Carboplatin (PC) in Epithelial Ovarian Cancer (EOC)
Reviewer: Thomas Dilling, MD
The Abramson Cancer Center of the University of Pennsylvania
Last Modified: May 20, 2002
Presenter: P.A. Vasey
Presenter's Affiliation: Scottish Gynaecological Cancer Trials Group
Type of Session: Scientific
- The Scottish Gynaecological Cancer Trials Group undertook a study of DC vs. PC in FIGO stage 1C-4 EOC.
- Data presented at ASCO last year demonstrated equivalent response rates in both arms.
- However, it was noted the DC patients had diminished neuropathy symptoms, though increased myelosuppression compared with patients on the PC arm.
Materials and Methods
- 1077 patients were enrolled from October, 1998 to May, 2000.
- Patients were randomized to DC or PC x 6 cycles.
- Median follow-up is now 23 months.
- Quality of Life (QOL) data was also obtained from patients during treatment and thereafter.
- Neurotoxicity data was also accumulated via patient questionnaire and serial neurologic exams.
- QOL tools included the EORTC QLQ-C30 (v. 3.0), which assesses global QOL.
- In addition, the researchers developed EORTC QLQ-OV28 (v. 1.0), a more specific module assessing domains more relevant to ovarian cancer patients. The presenter did not provide further information regarding development of this module or independent validation of its efficacy.
- To date, the PFS and OS curves overlap. The presenter states that an additional year of follow-up will be necessary to determine this with certainty.
- Median PFS is 15.4 months (PC) vs. 15.1 months (DC).
- 2-year OS is 69.8% (PC) vs. 65.4 months (DC).
- No significant interactions were found with patient age, extent of residual disease, or patient age.
- Global QOL scores, as ascertained by the QLQ-C30 were statistically comparable in both arms.
- More specific data from the QLQ-OV28, however, was highly significant, with all items assayed favoring DC.
- Specifically, the author mentioned the following as statistically significant in QOL analysis, all favoring the DC arm: neurotoxicity ("pins/needles and numbness"), myalgias ("aches and pains"), alopecia, weakness of the arms or legs, body image, pain scores, insomnia, gastrointestinal symptoms.
- The survival data in both arms appear to be equivalent (though data analysis is ongoing).
- QOL data, however, appeared to strongly favor the DC arm.
- As oncologists have shifted chemotherapeutic treatment from single-agent therapy to combinations of drugs, data on a number of various combinations have been accrued.
- Unfortunately, no single combination has proven greatly better than the others in the treatment of EOC.
- Given this fact, oncologists need to determine chemotherapeutic regimens that have equivalent survival data but diminished toxicity for the patient.
- Data on this study are still accruing, but thus far appear to favor DC over PC, by demonstrating equivalent tumor response, but with less disruption of patients' QOL perceptions.
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