title: Taxol in epithelial ovarian cancer.
abstract: Epithelial ovarian cancer is the fifth most common cause of cancer death in women. The management of patients with advanced disease involves surgery followed by platinum-based chemotherapy, but most patients will have either residual or recurrent disease. Salvage therapy in these patients is poor, with response rates less than 20%. Taxol, a new antineoplastic agent, was first noted to have activity in platinum-resistant ovarian cancer in a phase I study. Since then, response rates of 20% to 35% have been noted in several phase II studies involving hundreds of patients. Major toxicities include neutropenia and peripheral neuropathy. Taxol dose escalation with granulocyte-colony stimulating factor support, and Taxol in combination with cisplatin, have been tested and shown to be feasible. Intraperitoneal administration of Taxol is possible and appears advantageous from a pharmacokinetic perspective. A phase III study of Taxol and cisplatin in suboptimal disease was completed, and toxicity data show that Taxol administration is safe in a multi-institutional setting. Planned clinical development of Taxol includes use in less bulky stage III disease and dose escalation in platinum-resistant disease. Taxol has already become a major treatment of platinum-resistant disease. Further investigation will determine its role in the overall management of ovarian cancer.
authors.affiliation: Johns Hopkins Oncology Center, Baltimore, Md.
authors.forename: C
authors.initials: C
authors.lastname: Caldas
authors.forename: W P
authors.initials: WP
authors.lastname: McGuire
mesh_terms: D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D017239:Paclitaxel / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D016179:Granulocyte Colony-Stimulating Factor; D017239:Paclitaxel; D002945:Cisplatin