Hexamethylmelamine, cyclophosphamide, adriamycin, cis-platinum chemotherapy as initial and second-line treatment of advanced ovarian carcinoma.
Thirty-six patients with advanced/recurrent epithelial ovarian carcinoma were treated with a combination of hexamethylmelamine, cyclophosphamide, adriamycin, and cis-platinum. In the group of 23 previously untreated patients, 10 of 12 (83%) with measurable disease had objective responses (7 complete, 3 partial). The median survival of the 23 patients exceeded 18 months. After approximately 1 year of chemotherapy, 9 patients with no clinical evidence of disease had a 'second look' laparotomy; 6 of these patients were disease-free. Two of the 6 patients with surgically documented complete responses had bulky (greater than 5 cm) disease prior to initiation of chemotherapy and remained disease-free at 22 and 50 months. One of the 6 patients relapsed 5 months after a negative second look. The other patients were alive and disease-free at 18, 46, and 51 months. Only 4 of 13 melphalan-resistant patients (31%) demonstrated an objective response to the 4-drug combination. The median survival was 13 months.
Richman
C M
CM
Podczaski
E
E
Weiser
P A
PA
Herbst
A L
AL
D000328:Adult; D000368:Aged; D006585:Altretamine / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D012086:Reoperation
D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D008558:Melphalan; D006585:Altretamine