Carboplatin and etoposide as first-line chemotherapy in advanced epithelial ovarian cancer

Abstract

Carboplatin and etoposide are chemotherapeutic agents active in ovarian cancer, previously proved to have a synergistic activity in animal models. The objective of this phase II study was to determine the feasibility and the efficacy of the combination of carboplatin and etoposide in previously untreated patients with advanced epithelial ovarian cancer. Carboplatin, 400 mg m-2 day 1, and etoposide, 100 mg m-2 days 1-3 every 4 weeks were administered to 28 patients with advanced stage (III-IV) ovarian cancer and a performance status 0-2 (ECOG scale), as a firstline chemotherapy. Twenty-three patients were evaluable for response; 15 (65%) (95% CI: 45-81%) responded, 10 (43%) (95% CI: 25-63%) with clinical complete response. Pathologic complete response demonstrated during postchemotherapy laparotomy was noted in 5/23 (22%) (95% CI: 9-42%) patients. The median progression-free interval was 8.5 months, and median survival was 19.5 months. Toxicity, mainly hematologic, was severe. Nine (32%) patients experienced at least one episode of leucopenic fever, which consequently led to toxic deaths in two (7%) patients. The relatively low response and survival rates with increased toxicity rate are disappointing.

Chemotherapy Resistance in Advanced Ovarian Cancer Patients

“…76 Carboplatin and etoposide, which showed significant synergistic activity in animal models of ovarian cancer, had a relatively low CR of only 43% along with increased toxicity rate. 22 Combination of carboplatin, hexamethylmelamine and etoposide produced a very high CR of 92%; however, the study was on a very small sample size. 23 Carboplatin and cyclophosphamide combination proved to be effective in optimally debulked advanced ovarian cancer patients; however, the combination did not significantly prevent tumour progression in a majority of patients.…”