title: First-line chemotherapy with epirubicin, paclitaxel, and carboplatin for advanced ovarian cancer: a phase I/II study of the Arbeitsgemeinschaft Gynäkologische Onkologie Ovarian Cancer Study Group.
abstract: OBJECTIVE
  Despite the progress that has been achieved over the years, survival rates in patients with advanced ovarian cancer are still disappointing. New methods to improve the efficiency of first-line chemotherapy are warranted. One method to improve results is to add more non-cross-resistant drugs to platinum-paclitaxel combination regimens. Anthracyclines are among the candidates for incorporation as the "third drug" into first-line regimens for advanced ovarian cancer.
  
  
  METHODS
  We performed a phase I/II trial with escalating doses of epirubicin (60, 75, and 90 mg/m2) combined with fixed doses of paclitaxel and carboplatin in 27 previously untreated patients with advanced gynecologic malignancies.
  
  
  RESULTS
  Dose-limiting toxicity occurred at dose level 2 (75 mg/m2 epirubicin) and consisted of myelosuppression (neutropenia, thrombocytopenia). No dose-limiting, nonhematologic toxicities were observed. The maximum tolerable dose was epirubicin 60 mg/m2 (E) combined with a 3-hour infusion of paclitaxel 175 mg/m2 (T) and carboplatin AUC 5 (Carbo). Preliminary analysis indicated promising activity against ovarian cancer.
  
  
  CONCLUSIONS
  The three-drug combination ET-Carbo, given according to the outlined dose and schedule, should be considered for further phase III evaluation. A randomized German-French intergroup trial comparing ET-Carbo with carboplatin-paclitaxel has already been initiated.
authors.affiliation: Frauenklinik St. Vincentius Krankenhaus, Karlsruhe, Germany. dubois@klinik.uni-karlsruhe.de
authors.forename: A
authors.initials: A
authors.lastname: du Bois
authors.forename: H J
authors.initials: HJ
authors.lastname: Lück
authors.forename: T
authors.initials: T
authors.lastname: Bauknecht
authors.forename: W
authors.initials: W
authors.lastname: Meier
authors.forename: B
authors.initials: B
authors.lastname: Richter
authors.forename: W
authors.initials: W
authors.lastname: Kuhn
authors.forename: J
authors.initials: J
authors.lastname: Quaas
authors.forename: J
authors.initials: J
authors.lastname: Pfisterer
mesh_terms: D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000903:Antibiotics, Antineoplastic; D015251:Epirubicin; D016190:Carboplatin; D017239:Paclitaxel