Seminars in oncology
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Seminars in oncology · Feb 1999
ReviewPaclitaxel plus carboplatin in the treatment of ovarian cancer.
Two 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. ⋯ 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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Seminars in oncology · Feb 1999
ReviewCombining new agents with anthracyclines in metastatic breast cancer: an overview of recent findings.
Historically, doxorubicin has been the most effective single agent in metastatic breast cancer, and the combination of doxorubicin with other active agents (as in the 5-fluorouracil/doxorubicin/cyclophosphamide protocol) has improved patient outcome. Results from phase II and several recent phase III studies provide evidence that new agents are also highly active in the treatment of metastatic breast cancer and suggest that they would be active in combination regimens with the anthracyclines. ⋯ Studies to date indicate that this high response rate is achieved without accompanying cardiotoxicity. Several other new agents, notably, paclitaxel, vinorelbine, and gemcitabine, also have been evaluated in combination with the anthracyclines.