Only a limited number of patients with advanced ovarian cancer obtain a long-term disease-free interval. The purpose of this study is to find new active drugs and/or regimens. Carboplatin 200 mg m-2 day 1, cisplatin 50 mg m-2 days 2 and 3, and etoposide 70 mg m-2 i.v. days 1-5 every 4 weeks for six cycles were given to 43 previously untreated ovarian cancer patients with residual disease after primary laparotomy.
The median observation time was 75 months (range, 63-87 months). Forty-two patients were evaluable for response and the overall pathological response rate was 57% (pathologic complete response (PCR) plus pathological partial response (PPR)), with 26% being PCRs (11/42; 95% confidence interval, 0.14-0.42). The main hematologic toxicity was thrombocytopenia grade 3-4 which occurred in 95% of the cycles. Dose-limiting leucocytopenia only occurred in 21%. Non-hematologic toxicity caused dose-reduction in 33% of the patients, with nephrotoxicity being the main reason (24%).
The purpose of the study was to give a high total dose of platinum in combination with etoposide. However, this was not feasible due to excessive cumulative hematologic toxicity and nephrotoxicity. As the activity of the combination was no better than that obtained with other, less toxic regimens, the combination cannot be recommended.
- high-dose platinum
- ovarian cancer
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