Paclitaxel vs Epidoxorubicin plus Paclitaxel as Second-Line Therapy for Platinum-Refractory and -Resistant Ovarian Cancer

Efficacy of low‐dose topotecan in second‐line treatment for patients with epithelial ovarian carcinoma

“…Currently, three prospective, randomized studies have provided mature results in comparing different agents for the treatment of patients with platinum-resistant ovarian carcinoma. [7][8][9] Ten Bokkel et al demonstrated a potential advantage of standard-dose topotecan (1.5 mg/m 2 for 5 days every 3 weeks) compared with paclitaxel (175 mg/m 2 every 3 weeks), as manifested by higher response rates in patients with platinum-resistant disease (13.3% vs. 6.7%, respectively; P ϭ 0.30) and a significantly longer overall time to disease progression for all patients (23 weeks vs. 14 weeks, respectively; P ϭ 0.002). 7 In a recent, large trial of second-line treatment for patients with ovarian carcinoma, analysis of the subgroup of patients with platinum-resistant disease showed a statistically nonsignificant survival trend in favor of standard-dose topotecan, with a median survival of 9.5 months for patients who received topotecan compared with a median survival of 8.2 months for patients who received pegylated liposomal doxorubicin (P ϭ 0.455).…”

“…2 Currently, three prospective, randomized studies have provided mature results in comparing different drugs for the treatment of patients with platinumresistant disease; these studies have demonstrating similar activity with topotecan, liposomal doxorubicin, paclitaxel, and paclitaxel-epidoxorubicin with different toxicity profiles for the various regimens. [7][8][9] The implementation of additional randomized trials are hampered by the fact that the population of patients with platinum-resistant ovarian carcinoma has been used widely in Phase II trials of new agents or older agents in different combinations and schedules because of their general good performance status and reasonable life expectancy. 4 Therefore, retrospective studies on well-defined patient populations with epithelial ovarian carcinoma are valuable to elucidate the effect of the various agents and schedules to be used in forthcoming randomized trials of patients with platinum-resistant ovarian carcinoma.…”

Randomised controlled trial comparing single agent paclitaxel vs epidoxorubicin plus paclitaxel in patients with advanced ovarian cancer in early progression after platinum-based chemotherapy: an Italian Collaborative Study from the ‘Mario Negri’ Institute, Milan, G.O.N.O. (Gruppo Oncologico Nord Ovest) group and I.O.R. (Istituto Oncologico Romagnolo) group

“…The most important aspect emerging from this study, which, to our knowledge, is one of the largest phase III randomised trials ever performed in recurrent ovarian cancer, is that the combination of two noncrossresistant drugs failed to achieve better results and was associated to an higher toxicity than the single agent paclitaxel in the management of advanced ovarian cancer patients in early progression after platinum-based chemotherapy. Our data can be compared with the results emerged from the study of Bolis et al (1999). In this multicenter phase III randomized trial, combination of paclitaxel plus epidoxorubicin gave a higher response rate than single agent paclitaxel.…”

Gemcitabine-oxaliplatin combination for ovarian cancer resistant to taxane-platinum treatment: a phase II study from the GINECO group

“…Our non-randomised study cannot provide a clear-cut answer to this fundamental question. Several studies in resistant ovarian cancer patients have failed to find a median PFS or OS advantage of combinations of doxorubicin or epirubicin with paclitaxel over paclitaxel alone, or of doublets including topotecan over topotecan alone, suggesting that nonplatinum single-agent therapy might be the most appropriate treatment in this setting (Bolis et al, 1999;Buda et al, 2004;Sehouli et al, 2008). The median time to progression of 4.6 months and the median OS of 11.4 months in resistant or refractory patients treated with OXA and GE in our study also appear comparable to survival durations reported in earlier trials of liposomal pegylated doxorubicin, topotecan or weekly paclitaxel used as single agents (Gordon et al, 2001;Markman et al, 2006).…”