WEEKLY TREATMENT FOR OVARIAN CANCER

Gynecol Oncol. 2013 Jul 10. pii: S0090-8258(13)00846-9. doi: 10.1016/j.ygyno.2013.06.013. [Epub ahead of print]

Weekly carboplatin with paclitaxel compared to standard three-weekly treatment in advanced epithelial ovarian carcinoma - a retrospective study.

Safra T, Shamai S, Greenberg J, Veizman A, Shpigel S, Matcejevsky D, Pelles S, Inbar M, Levy T, Grisaru D.

Source

Department of Oncology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: safrat@bezeqint.net.

Abstract

OBJECTIVE:

To retrospectively compare primary treatment with weekly carboplatin/paclitaxel (PC-W) to the standard 3-weekly carboplatin/paclitaxel (PC-3W) in women with advanced epithelial ovarian cancer, tubal carcinoma and primary peritoneal carcinoma.

METHODS:

Medical records were assessed for age, stage of disease, tumor histology and grade, BRCA mutation status, and platinum sensitivity. Patients were treated with either paclitaxel (175mg/m²) and carboplatin (AUC 6) every three weeks (PC-3W; 133 patients), or with weekly paclitaxel (80mg/m²) and weekly carboplatin (AUC 2) on days 1, 8, and 15 every 28days (PC-W; 267 patients).

RESULTS:

Patient baseline characteristics were similar in both groups. Median overall survival (OS) was similar for PC-W and PC-3W (64.5months vs. 61.5months), but PC-W had longer median progression-free survival [PFS: 27.4months (95% CI, 22.7-31.4) vs. 19.5months (95% CI, 15.6-22.2) for PC-3W, p=0.0024] and a longer median platinum-free interval [PFI: 22.1months (95% CI, 16.0-24.5) vs. 14.2months (95% CI, 10.7-17.2) for PC-3W, p=0.0075]. PC-W showed a significantly higher response rate (86.4% vs. 77.9% for PC-3W, p=0.0435). Multivariate analysis including for age at diagnosis, stage of disease, optimal debulking, histology, BRCA status, pretreatment CA-125 and PFI revealed that the PC-W women had lower risk of death (HR=0.587, 95% CI, 0.402-0.857, p=0.0058), lower risk of disease progression (HR=0.494, 95% CI, 0.359-0.680, p<0 .0001="" 2-="" 3-year="" and="" compared="" decreased="" grade="" hair="" higher="" ii="" loss="" neuropathy="" p="" pc-3w="" rates="" survival="" the="" thrombocytopenia="" with="" women.="">

CONCLUSION:

The PC-W protocol improved PFS and had a similar OS as PC-3W.