title: Combined cisplatin and carboplatin chemotherapy for treatment of advanced epithelial ovarian cancer.
abstract: OBJECTIVE
  The primary goal of this trial was to evaluate the clinical activity and the toxicity of a combination of cisplatin and carboplatin for women with advanced-stage epithelial ovarian cancer.
  
  
  METHODS
  Fifty-one consecutive evaluable patients with untreated stage III and IV epithelial ovarian cancer received 360 mg/m2 carboplatin on Day 1 and 50 mg/m2 cisplatin on Day 2 administered intravenously every 28 days for six cycles. Drug doses were adjusted for hematologic toxicity based on nadir counts during the prior therapy course. Dose levels included 300-400 mg/m2 carboplatin and 50-75 mg/m2 cisplatin. Second-look surgery was optional. Endpoints were clinical response, surgical response, progression-free survival, and survival.
  
  
  RESULTS
  Of 8 patients with measurable disease, 3 (37.5%) had a clinical compete response, and 3 (37.5%) had a clinical partial response, for an overall clinical response rate of 75%. Of 39 patients who began chemotherapy with abnormal serum levels of CA 125, 31 (79%) achieved normalization of CA 125 at the completion of chemotherapy. Thirteen patients underwent second-look laparotomy. Of these, 7 (54%) had a pathological compete response, and 2 (15%) had a partial response. The median progression-free survival was 14 months, and the overall median survival was 32.5 months. Neutropenia and thrombocytopenia were the main dose-limiting toxicities. In addition, 9 patients developed grade 2 and 3 developed grade 3 ototoxicity.
  
  
  CONCLUSIONS
  This regimen is very active against advanced-stage epithelial ovarian cancer. The degree of ototoxicity observed is worrisome, but such toxicity may be ameliorated by limiting the dose of cisplatin and increasing the dose of carboplatin.
authors.affiliation: Department of Gynecologic Oncology, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Gershenson
authors.forename: M
authors.initials: M
authors.lastname: Morris
authors.forename: T W
authors.initials: TW
authors.lastname: Burke
authors.forename: C
authors.initials: C
authors.lastname: Levenback
authors.forename: J J
authors.initials: JJ
authors.lastname: Kavanagh
authors.forename: G L
authors.initials: GL
authors.lastname: Fromm
authors.forename: E G
authors.initials: EG
authors.lastname: Silva
authors.forename: D
authors.initials: D
authors.lastname: Warner
authors.forename: J T
authors.initials: JT
authors.lastname: Wharton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D011446:Prospective Studies; D016019:Survival Analysis
chemical_list: D016190:Carboplatin; D002945:Cisplatin