title: The CHAD and HAD regimens in advanced ovarian cancer: combination chemotherapy including cyclophosphamide, hexamethylmelamine, adriamycin, and cis-dichlorodiammineplatinum(II).
abstract: Combination chemotherapy consisting of hexamethylmelamine, adriamycin, and cis-dichlorodiammineplatinum(II) was given to 27 patients with advanced epithelial ovarian cancer whose disease had progressed while receiving therapy including alkylating agents. Eighteen patients (67%) had objective partial or complete remissions for a projected median duration of 7 months. Based on this high level of activity in this poor-risk group, the three drugs were combined with cyclophosphamide in a four-drug regimen (CHAD) for initial therapy suitable for outpatient administration. Nineteen of 21 evaluable patients (90.4%) receiving CHAD responded. Complete clinical remissions were noted in ten patients (47.6%) and were confirmed at "second-look" laparotomy in two of these. An additional five patients without evaluable disease after initial surgery are free from relapse at 4--15 months. Toxicity was only moderately severe; 28% of the patients had wbc counts less than 2000/microliters at some point. Nephrotoxicity from cis-dichlorodiammineplatinum(II) was almost completely prevented by a 2-hour outpatient regimen of hydration and diuresis. A prospective randomized trial is planned comparing CHAD to melphalan in previously untreated women with advanced ovarian cancer.
mesh_terms: D000328:Adult; D000368:Aged; D000477:Alkylating Agents / Q000494:pharmacology; D006585:Altretamine / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001853:Bone Marrow / Q000187:drug effects; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004341:Drug Evaluation; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy*
chemical_list: D000477:Alkylating Agents; D000970:Antineoplastic Agents; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D006585:Altretamine