Carboplatin/Paclitaxel Preferable to Cisplatin/Paclitaxel in Optimal Stage III Epithelial Ovarian Cancer
University of Pennsylvania Cancer Center
Last Modified: May 16, 1999
Robert Ozols, M.D. from the Fox Chase Cancer Center presented data from the Gynecologic Oncology Group (GOG) Protocol #158 a randomized Phase III clinical trial of cisplatin/paclitaxel versus carboplatin/paclitaxel in optimally surgically cytoreduced epithelial ovarian cancer. This important study is the largest reported randomized trial in optimal Stage III ovarian cancer.
The regimen for GOG 158 was as follows:
- Regimen 1: Cisplatin 75 mg/m2 IV and paclitaxel 135 mg/m2 IV over 24 hours for six cycles
- Regimen 2: Carboplatin AUC 7.5 and paclitaxel 175 mg/m2 IV over 3 hours for six cycles.
- A total of 840 patients were entered into the study.
- Approximately half of the patients were registered for second-look surgery (SLS). There was no significant difference in disease free survival for the SLS and non-SLS groups.
- Gastrointestinal, leukopenia, fever, and metabolic toxicity were greater in regimen 1.
- Thrombocytopenia and pain were more common in regimen 2.
- Both regimens are equivilent in effacacy at the limit of power for this study.
- Regimen 2 (Carboplatin and 3-hour paclitaxel) is the preferable regimen because of ease of administration and less toxicity.
- Second-look surgery does not influence recurrence free survival in optimal Stage IIIC ovarian cancer