Sequential Couplets of Cisplatin/Topotecan and Cisplatin/Paclitaxel as First-Line Therapy in Advanced Epithelial Ovarian Cancer

University of Pennsylvania Cancer Center
Last Modified: May 16, 1999

Dr. P. Hoskins presented a Phase II trial of sequential couplets of cisplatin (DDP) and topotecan (TOP) and cisplatin and paclitaxel (T) as first-line therapy for advanced epithelial ovarian cancer on behalf of the National Cancer Institute of Canada. The dosage used were as follows:

DDP/TOP cycles: DDP 50 mg/m2 and TOP 0.75 mg/m2

DDP/T cycles: DDP 75 mg/m2 and T 135 mg/m2 IV infusion over 24 hours

Interval debulking was allowed.

Dr. Hoskins reported that:

  • Dose reduction was needed in 13% of DDP/TOP cycles

  • Dose delays were incurred in 9% of DDP/TOP cycles

  • A response rate of 85%
Dr. Hoskins concluded that:
  • Myelotoxcity of this couplet regimen is high but does not prevent delivery.

  • The response rate is encouraging being that these were predominately suboptimal patients.
This presentation was discussed by David Spriggs, M.D. from Memorial Sloan-Kettering Cancer Center. Dr. Spriggs had reservations:
  • Cisplatin was used instead of carboplatin

  • Marked reduction in topotecan dosing

  • Treatment delay was common

  • Substantial toxicity