Carboplatin and paclitaxel versus cisplatin, paclitaxel and doxorubicin for first-line chemotherapy of advanced ovarian cancer: a Hellenic Cooperative Oncology Group (HeCOG) study.
BACKGROUND
The combination of Carboplatin and Paclitaxel is considered the standard of care as initial chemotherapy for Advanced Ovarian Cancer (AOC). We compared this regimen with the combination of Cisplatin, Paclitaxel and Doxorubicin.


METHODS
Patients with AOC were randomised to either six courses of Paclitaxel 175mg/m(2) plus Carboplatin 7AUC or Paclitaxel at the same dose plus Cisplatin 75mg/m(2) plus Doxorubicin 40mg/m(2).


RESULTS
Analysis was performed on 451 patients. The treatment groups were well balanced with regard to patient and disease characteristics. Performance status (PS) was better in the anthracycline arm. In terms of severe toxicity, the only significant difference between the two groups was the development of febrile neutropaenia in the anthracycline arm. Overall response rate was similar in both groups. With a median follow-up of 57.5 months, a marginal significance towards improved Progression-Free Survival (PFS) was noted in favour of the anthracycline arm, whilst there was no difference in overall survival. In multivariate analysis the hazard of disease progression at any time was significantly decreased by 25.5% for patients of the anthracycline arm.


CONCLUSIONS
The combination of Cisplatin, Paclitaxel and Doxorubicin demonstrates a marginal PFS improvement, but no additional survival benefit when compared with the standard Carboplatin/Paclitaxel regimen.
Aravantinos
Gerasimos
G
Agii Anargiri Cancer Hospital, Hellenic Cooperative Oncology Group, Hatzikonstanti 18,115 24 Athens, Greece. hecogaga@otenet.gr
Fountzilas
George
G
Bamias
Aristotelis
A
Grimani
Irene
I
Rizos
Spyridon
S
Kalofonos
Haralabos P
HP
Skarlos
Dimosthenis V
DV
Economopoulos
Theofanis
T
Kosmidis
Paris A
PA
Stathopoulos
George P
GP
Briasoulis
Evangelos
E
Pectasides
Dimitrios
D
Samantas
Epaminondas
E
Timotheadou
Eleni
E
Papadimitriou
Christos
C
Papanikolaou
Alexandros
A
Onyenadum
Adimchi
A
Papakostas
Pavlos
P
Bafaloukos
Dimitrios
D
Dimopoulos
Meletios A
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D010349:Patient Compliance; D016896:Treatment Outcome
D004317:Doxorubicin; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin