First‐Line Treatment of Ovarian Cancer: Weekly Carboplatin/Paclitaxel Versus Standard Regimen
Posted: Tuesday, October 27, 2020
In a study published in The Oncologist, a team of investigators, led by Ido Wolf, MD, of Tel Aviv Sourasky Medical Center, Israel, indicated weekly carboplatin and paclitaxel first-line therapy may be as active and better tolerated than the standard regimen of carboplatin and paclitaxel in patients with advanced ovarian cancer. The investigators set out to assess weekly scheduling of paclitaxel, since it has been suggested to increase its efficacy by reducing tumor regrowth between cycles and maximizing the drug’s antiangiogenic effect.
The three‐weekly regimen (PC‐3W) consisted of the conventional doublet paclitaxel at 175 mg/m2 and carboplatin AUC = 6, on day 1 of a 21‐day cycle repeated for six cycles. The weekly regimen (PC‐W) consisted of paclitaxel at 80 mg/m2 and carboplatin AUC = 2 administered on days 1, 8, and, 15 of a 28‐day cycle, repeated for six cycles.
Of note, CA-125 levels were evaluated every three cycles during chemotherapy. Complete blood cell count was performed before each treatment. A confirmed increase in serum CA-125 levels to more than twice the upper limit of normal (35 U/dL) was considered as disease progression for patients with no corresponding imaging evidence of disease.
According to the final data, disease recurred in 197 patients (64.6%) in the PC‐W group and in 298 patients (74.1%) in the PC‐3W group. After adjustment for age, stage, debulking, BRCA analysis, and histologic type, the hazard ratio was 0.53 in favor of the PC‐W group. A higher percentage of patients in the PC‐W group had platinum‐sensitive disease (88.9% vs. 76.3%).
“As prospective trials comparing the two regimens are lacking, the results of this analysis highlight the modified dose-dense weekly regimen as a valid treatment option, especially for elderly patients and those with significant comorbidities,” concluded the authors.
Disclosure: The study authors reported no conflicts of interest.
