Randomized Trial in Advanced Ovarian Cancer Comparing Cisplatin and Carboplatin

Abstract

The aim of this multicenter randomized trial was to compare carboplatin (400 mg/m2) and cisplatin (100 mg/m2) in patients with untreated advanced epithelial ovarian cancer. Toxicity and treatment efficacy assessed by pathological response rate, progression-free survival, and survival were the endpoints of the study. One hundred seventy-three patients with advanced epithelial ovarian cancer, F.I.G.O. (International Federation of Gynecology and Obstetrics) stage III and IV were accrued in the trial. The median follow-up time was 15 months (maximum, 34); three patients in each treatment arm were not eligible (four, nonepithelial ovarian cancer type; one, no data, and one, stage II). Patient characteristics were similar in the two groups. In the carboplatin-treatment arm, the overall pathological response rate was 57.3% and the complete pathological response rate was 26.8%. In the cisplatin-treatment arm, the overall pathological response rate was 71.6% and the complete pathological response rate was 24.7%. There was no statistical difference in the two arms in survival or progression-free survival. Cisplatin was more nephrotoxic while carboplatin induced a higher degree of myelosuppression, especially thrombocytopenia; however, severe hematological toxicity was seldom observed. Carboplatin is a cisplatin analog with definite activity in ovarian cancer, but it is more active than the parent compound. Because of less nonhematological toxicity, carboplatin is undoubtedly a useful substitute in patients who cannot be given cisplatin. Further experience is needed to indicate whether or not carboplatin should completely displace cisplatin in the clinical treatment of ovarian cancer.

Effects of interleukin-3 on myelosuppression induced by chemotherapy for ovarian cancer and small cell undifferentiated tumours

“…No severe nephrotoxicity has been encountered in our earlier studies, in which patients were treated with 800 mg m-2 carboplatin alone or in combination with GM-CSF (Ten Bokkel Huinink et al, 1992). In published series, the incidence of renal side effects with carboplatin has varied from 0% to 35% (Calvert et al, 1982;Adams et al, 1989;Mangioni et al, 1989). Acute renal failure attributable to this drug is rare and only a few cases of renal failure have been reported in the literature (Curt et al, 1983;Lee et al, 1988;McDonald et al, 1991).…”

First-line treatment for advanced ovarian cancer: paclitaxel, platinum and the evidence

“…In particular, this meta-analysis included three trials which had compared single agent cisplatin at 100 mg m 72 against single agent carboplatin at 400 mg m 72 (Adams et al, 1989;Mangioni et al, 1989;Taylor et al, 1994). These trials individually and together indicated equivalence between these regimens; the pooled hazard ratio was 1.01 (95%CI 0.81, 1.26) with no evidence of heterogeneity (w 2 (het) =0.02, P=0.99).…”

Carboplatin in Combination with Epirubicin and Cyclophosphamide in Patients with Advanced Ovarian Cancer: A phase II study

“…This was confirmed in two other studies with the same regimens (13,14). There are several randomized studies comparing the two agents in multidrug chemotherapy ( 1 I, 12, 15-18).…”