• R F Ozols.
• Medical Science Division, Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
• Semin. Oncol. 1999 Feb 1; 26 (1 Suppl 2): 84-9.

AbstractTwo large, prospective randomized trials by the Gynecologic Oncology Group and the European Organization for Research and Treatment of Cancer have demonstrated the superiority of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ)/cisplatin compared with cisplatin/cyclophosphamide in previously untreated patients with advanced ovarian cancer. Patients receiving the paclitaxel combination had a higher overall response rate, a longer time to disease progression, and prolonged median survival. In an effort to reduce toxicity, investigators developed combinations of carboplatin/paclitaxel that were found by phase I/II trials to have activity comparable to cisplatin/paclitaxel but with less toxicity. Prospective randomized trials of paclitaxel/cisplatin versus paclitaxel/carboplatin were completed by the Gynecologic Oncology Group and by European investigators and preliminary results identify no differences in efficacy. Clinical trials of new combinations of paclitaxel/carboplatin with oral etoposide, gemcitabine, or epirubicin have recently begun. Additional studies of high-dose chemotherapy regimens of paclitaxel/carboplatin in untreated patients with optimal stage III ovarian cancer also are in progress. The Gynecologic Oncology Group has completed a randomized comparison of three versus six cycles of paclitaxel/carboplatin in early stage disease. This study will be followed by a trial in which all patients with poor-prognosis, early stage ovarian cancer receive three cycles of paclitaxel/carboplatin followed by randomization to no further treatment or to weekly paclitaxel. The combination of paclitaxel/carboplatin is currently the preferred regimen for the treatment of ovarian cancer.

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