title: A randomised comparison of treosulfan and carboplatin in patients with ovarian cancer: a study by the Scottish Gynaecological Cancer Trials Group (SGCTG).
abstract: The management of older and unfit women with advanced ovarian cancer requires post-operative chemotherapy but many of these patients are not suitable for high-dose cisplatin-based regimes. Carboplatin has been an easier alternative and can be given in the ambulatory setting. Historical data suggests that oral alkylating agents to be just effective with similar efficacy. In this study we have compared platinum-based carboplatin to the alkylating agent treosulfan in a population unfit to receive high-dose cisplatin. The trial randomised patients to either intravenous carboplatin or treosulfan as single agent. The trial was stopped prematurely after the interim analysis showed improved survival and response rates in the carboplatin arm. We conclude that carboplatin is a safe and effective drug in a population that is unfit for high-dose cisplatin. Treosulfan showed limited activity but may be considered along with other oral drugs in limited circumstances. With the exception of myelosuppression, toxicity was mild in both arms. Carboplatin remains the gold standard in this older and less fit group of patients.
authors.affiliation: Beatson Oncology Centre, Western Infirmary, EORTC Gynaecological Cancer Group, Dumbarton Road, Glasgow G11 6NT, UK. nick.reed@northglasgow.scot.nhs.uk
authors.forename: N S
authors.initials: NS
authors.lastname: Reed
authors.forename: C J
authors.initials: CJ
authors.lastname: Poole
authors.forename: R
authors.initials: R
authors.lastname: Coleman
authors.forename: D
authors.initials: D
authors.lastname: Parkin
authors.forename: J D
authors.initials: JD
authors.lastname: Graham
authors.forename: S B
authors.initials: SB
authors.lastname: Kaye
authors.forename: J
authors.initials: J
authors.lastname: Ostrowski
authors.forename: I
authors.initials: I
authors.lastname: Duncan
authors.forename: J
authors.initials: J
authors.lastname: Paul
authors.forename: A
authors.initials: A
authors.lastname: Hay
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D002066:Busulfan / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018394:CA-125 Antigen / Q000378:metabolism; D016190:Carboplatin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D011788:Quality of Life; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D018394:CA-125 Antigen; D016190:Carboplatin; C018404:treosulfan; D002066:Busulfan