Sequential Combination of Paclitaxel-Carboplatin and Paclitaxel-Liposomal Doxorubicin as a First-Line Treatment in Patients with Ovarian Cancer

Vol. 69, No. 4, 2005

Free Abstract Article (Fulltext) Article (PDF 95 KB)

Clinical Study

Sequential Combination of Paclitaxel-Carboplatin and Paclitaxel-Liposomal Doxorubicin as a First-Line Treatment in Patients with Ovarian Cancer
A Multicenter Phase II Trial
Anna Potamianou^a, Nikolaos Androulakis^b, Pavlos Papakotoulas^c, Helen Toufexi^d, Christos Latoufis^e, Charalambos Kouroussis^b, Charalambos Christofilakis^f, Nikolaos Xenidis^b, Vassilios Georgoulias^b, Aristidis Polyzos^d

^aFirst Department of Medical Oncology 'Metaxa' Anticancer Hospital, Pireas,
^bDepartment of Medical Oncology, University General Hospital of Heraklion, Heraklion,
^cMedical Oncology Unit, Theagenion Anticancer Hospital, Thessaloniki,
^dMedical Oncology Unit, Laikon General Hospital, Athens University School of Medicine,
^eMedical Oncology Unit, 'ELPIS' Hospital, and
^fMedical Oncology Unit, Department of Medical Oncology, 401 Military Hospital of Athens, Athens, Greece

Address of Corresponding Author

Oncology 2005;69:348-353 (DOI: 10.1159/000089767)

Key Words

Carboplatin
Liposomal doxorubicin
Ovarian cancer
Paclitaxel

Abstract

Cisplatin or carboplatin plus paclitaxel is considered the standard first-line treatment in ovarian cancer. Attempts to maximize tumor cytoreduction with first-line chemotherapy by incorporating new promising agents led to sequential drug administration with two or three doublets. In the present study, we aimed to evaluate the activity and the tolerance of two sequential doublets (paclitaxel/carboplatin and liposomal doxorubicin/carboplatin) administered as first-line treatment in patients with FIGO III/IV ovarian cancer. Treatment consisted of four cycles of carboplatin (6 AUC) plus paclitaxel (175 mg/m²; PC regimen) followed by four cycles with carboplatin (6 AUC) plus liposomal doxorubicin (40 mg/m²; LD/C regimen) every 3 weeks. Forty-one patients in FIGO III or IV were enrolled. In an intention-to-treat analysis, 20 (49%) complete (CR) and 12 (29%) partial (PR) responses were achieved (overall response rate, ORR: 78%; 95% confidence interval, CI: 64.1-91.9%); with the PC regimen (164 cycles); 7 (17%) patients have stable (SD) and 2 (5%) progressive (PD) disease. The LD/C regimen (124 cycles) was administered in 36 (88%) patients because of 2 early deaths and 3 patient withdrawals. Three additional patients, 2 with PR and 1 with SD after PC chemotherapy) achieved a CR. Upon completion of the LD/C chemotherapy there were 18 (44%) patients with CR and 9 (22%) with PR (ORR = 66%; 95% CI: 64-92%). The median duration of response was 27 months and the median time to progression 20 months. The probability of 2-year survival was 67%. Grade 3 and 4 neutropenia was observed in 34 and 14.6% of the patients, respectively, during the PC regimen, while during the treatment with LD/C the percentages for grade 3 and 4 neutropenia were 44.4 and 19.4%, respectively. Febrile neutropenia occurred only in patients treated with the PC regimen (4.9%). The incorporation of liposomal doxorubicin in this sequential doublet schedule of first-line treatment of ovarian carcinoma created a feasible and active regimen. Prospective randomized studies are required to assess its efficacy on patient survival.

Author Contacts

Assoc. Prof. Aristides Polyzos
First Department of Propaedeutic Medicine, Laikon General Hospital
17, Agiou Thoma street, Goudi, GR-11527 Athens (Greece)
Tel. +30 210 7706606, Fax +30 210 7791839
E-Mail panoraiap@med.uoa.gr and r-e-poly@hol.gr

Article Information

Received: March 1, 2005
Accepted after revision: June 25, 2005
Published online: November 16, 2005
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 3, Number of References : 21

Medline Abstract (ID 16293974)

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