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A correction has been published: N Engl J Med 1996;334(19):1268.

Volume 334:1-6 January 4, 1996 Number 1 Next

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ABSTRACT

Background Chemotherapy combinations that include an alkylating agent and a platinum coordination complex have high response rates in women with advanced ovarian cancer. Such combinations provide long-term control of disease in few patients, however. We compared two combinations, cisplatin and cyclophosphamide and cisplatin and paclitaxel, in women with ovarian cancer.

Methods We randomly assigned 410 women with advanced ovarian cancer and residual masses larger than 1 cm after initial surgery to receive cisplatin (75 mg per square meter of body-surface area) with either cyclophosphamide (750 mg per square meter) or paclitaxel (135 mg per square meter over a period of 24 hours).

Results Three hundred eighty-six women met all the eligibility criteria. Known prognostic factors were similar in the two treatment groups. Alopecia, neutropenia, fever, and allergic reactions were reported more frequently in the cisplatin–paclitaxel group. Among 216 women with measurable disease, 73 percent in the cisplatin–paclitaxel group responded to therapy, as compared with 60 percent in the cisplatin–cyclophosphamide group (P = 0.01). The frequency of surgically verified complete response was similar in the two groups. Progression-free survival was significantly longer (P<0.001) in the cisplatin–paclitaxel group than in the cisplatin–cyclophosphamide group (median, 18 vs. 13 months). Survival was also significantly longer (P<0.001) in the cisplatin–paclitaxel group (median, 38 vs. 24 months).

Conclusions Incorporating paclitaxel into first-line therapy improves the duration of progression-free survival and of overall survival in women with incompletely resected stage III and stage IV ovarian cancer.

Source Information

From the Department of Medicine, Emory University, Atlanta (W.P.M.); the Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, and the Department of Obstetrics and Gynecology, Cornell University Medical College, New York (W.J.H.); the Gynecologic Oncology Group Statistical Office, Roswell Park Cancer Institute, Buffalo, N.Y. (M.F.B.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Oregon Health Sciences University, Portland (P.R.K.); the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Alabama at Birmingham, Birmingham (E.E.P.); the Division of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis (K.Y.L.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, N.C. (D.L.C.-P.); and the Department of Pathology and Area Laboratory Sciences, Walter Reed Army Medical Center, Washington, D.C. (M.D.).

Address reprint requests to Dr. McGuire at the GOG Administrative Office, Suite 1945, 1234 Market St., Philadelphia, PA 19107.

Full Text of this Article

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Chemotherapy for Ovarian Cancer
Parmar M. K.B., Sandercock J., Cvitkovic E., Misset J.-L., Lacave A. J., Peláez I., Palacio I., McGuire W.P., Hoskins W.J., Brady M.F.
Extract | Full Text  
N Engl J Med 1996; 334:1268-1270, May 9, 1996. Correspondence

BRCA1 Mutations and Survival in Women with Ovarian Cancer
Cannistra S. A., Whitmore S. E., Burk R. D., Modan B., Johannsson O., Ranstam J., Borg A., Olsson H., Brunet J.-S., Narod S. A., Tonin P., Foulkes W. D., Rubin S. C.
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N Engl J Med 1997; 336:1254-1257, Apr 24, 1997. Correspondence

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• Spentzos, D., Levine, D. A., Ramoni, M. F., Joseph, M., Gu, X., Boyd, J., Libermann, Towia. A., Cannistra, S. A. (2004). Gene Expression Signature With Independent Prognostic Significance in Epithelial Ovarian Cancer. JCO 22: 4700-4710 [Abstract] [Full Text]  
• Vasey, P. A., Jayson, G. C., Gordon, A., Gabra, H., Coleman, R., Atkinson, R., Parkin, D., Paul, J., Hay, A., Kaye, S. B., On behalf of the Scottish Gynaecological Cancer Tr, (2004). Phase III Randomized Trial of Docetaxel-Carboplatin Versus Paclitaxel-Carboplatin as First-line Chemotherapy for Ovarian Carcinoma. JNCI J Natl Cancer Inst 96: 1682-1691 [Abstract] [Full Text]  
• Sabbatini, P., Aghajanian, C., Dizon, D., Anderson, S., Dupont, J., Brown, J. V., Peters, W. A., Jacobs, A., Mehdi, A., Rivkin, S., Eisenfeld, A. J., Spriggs, D. (2004). Phase II Study of CT-2103 in Patients With Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Carcinoma. JCO 22: 4523-4531 [Abstract] [Full Text]  
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• Herzog, T. J. (2004). Recurrent Ovarian Cancer: How Important Is It to Treat to Disease Progression?. Clin. Cancer Res. 10: 7439-7449 [Abstract] [Full Text]  
• Mabuchi, S., Ohmichi, M., Nishio, Y., Hayasaka, T., Kimura, A., Ohta, T., Kawagoe, J., Takahashi, K., Yada-Hashimoto, N., Seino-Noda, H., Sakata, M., Motoyama, T., Kurachi, H., Testa, J. R., Tasaka, K., Murata, Y. (2004). Inhibition of Inhibitor of Nuclear Factor-{kappa}B Phosphorylation Increases the Efficacy of Paclitaxel in in Vitro and in Vivo Ovarian Cancer Models. Clin. Cancer Res. 10: 7645-7654 [Abstract] [Full Text]  
• Sironi, S., Messa, C., Mangili, G., Zangheri, B., Aletti, G., Garavaglia, E., Vigano, R., Picchio, M., Taccagni, G., Maschio, A. D., Fazio, F. (2004). Integrated FDG PET/CT in Patients with Persistent Ovarian Cancer: Correlation with Histologic Findings. Radiology 233: 433-440 [Abstract] [Full Text]  
• Huang, G.-C., Liu, S.-Y., Lin, M.-H., Kuo, Y.-Y., Liu, Y.-C. (2004). The Synergistic Cytotoxicity of Cisplatin and Taxol in Killing Oral Squamous Cell Carcinoma. Jpn J Clin Oncol 34: 499-504 [Abstract] [Full Text]  
• Onda, T., Katsumata, N., Tsunematsu, R., Yasugi, T., Mushika, M., Yamamoto, K., Fujii, T., Hirakawa, T., Kamura, T., Saito, T., Yoshikawa, H. (2004). Cisplatin, Paclitaxel and Escalating Doses of Doxorubicin (TAP) in Advanced Ovarian Cancer: a Phase I Trial. Jpn J Clin Oncol 34: 540-546 [Abstract] [Full Text]  
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• Cao, Z., Fang, J., Xia, C., Shi, X., Jiang, B.-H. (2004). trans-3,4,5'-Trihydroxystibene Inhibits Hypoxia-Inducible Factor 1{alpha} and Vascular Endothelial Growth Factor Expression in Human Ovarian Cancer Cells. Clin. Cancer Res. 10: 5253-5263 [Abstract] [Full Text]  
• De Placido, S., Scambia, G., Di Vagno, G., Naglieri, E., Lombardi, A. V., Biamonte, R., Marinaccio, M., Carteni, G., Manzione, L., Febbraro, A., de Matteis, A., Gasparini, G., Valerio, M. R., Danese, S., Perrone, F., Lauria, R., De Laurentiis, M., Greggi, S., Gallo, C., Pignata, S. (2004). Topotecan Compared With No Therapy After Response to Surgery and Carboplatin/Paclitaxel in Patients With Ovarian Cancer: Multicenter Italian Trials in Ovarian Cancer (MITO-1) Randomized Study. JCO 22: 2635-2642 [Abstract] [Full Text]  
• Gelmon, K. A., Stewart, D., Chi, K. N., Chia, S., Cripps, C., Huan, S., Janke, S., Ayers, D., Fry, D., Shabbits, J. A., Walsh, W., McIntosh, L., Seymour, L. K. (2004). A phase I study of AMD473 and docetaxel given once every 3 weeks in patients with advanced refractory cancer: a National Cancer Institute of Canada-Clinical Trials Group trial, IND 131. Ann Oncol 15: 1115-1122 [Abstract] [Full Text]  
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• Sabbatini, P., Aghajanian, C., Leitao, M., Venkatraman, E., Anderson, S., Dupont, J., Dizon, D., O'Flaherty, C., Bloss, J., Chi, D., Spriggs, D. (2004). Intraperitoneal Cisplatin with Intraperitoneal Gemcitabine in Patients with Epithelial Ovarian Cancer: Results of a Phase I/II Trial. Clin. Cancer Res. 10: 2962-2967 [Abstract] [Full Text]  
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• Hess, V., A'Hern, R., Nasiri, N., King, D. M., Blake, P. R., Barton, D. P.J., Shepherd, J. H., Ind, T., Bridges, J., Harrington, K., Kaye, S. B., Gore, M. E. (2004). Mucinous Epithelial Ovarian Cancer: A Separate Entity Requiring Specific Treatment. JCO 22: 1040-1044 [Abstract] [Full Text]  
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• Apte, S. M., Fan, D., Killion, J. J., Fidler, I. J. (2004). Targeting the Platelet-Derived Growth Factor Receptor in Antivascular Therapy for Human Ovarian Carcinoma. Clin. Cancer Res. 10: 897-908 [Abstract] [Full Text]  
• Markman, M. (2004). Ethical Conflict in Providing Informed Consent for Clinical Trials: A Problematic Example from the Gynecologic Cancer Research Community. The Oncologist 9: 3-7 [Abstract] [Full Text]  
• Hochster, H., Plimack, E. R., Runowicz, C. D., Speyer, J., Wallach, R. C., Sorich, J., Mandeli, J., Wadler, S., Wright, J., Muggia, F. M. (2004). Biweekly 72-Hour 9-Aminocamptothecin Infusion As Second-Line Therapy for Ovarian Carcinoma: Phase II Study of the New York Gynecologic Oncology Group and the Eastern Cooperative Oncology Group. JCO 22: 120-126 [Abstract] [Full Text]  
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• Yoshida, Y., Kurokawa, T., Kawahara, K., Tsuchida, T., Okazawa, H., Fujibayashi, Y., Yonekura, Y., Kotsuji, F. (2004). Incremental Benefits of FDG Positron Emission Tomography over CT Alone for the Preoperative Staging of Ovarian Cancer. Am. J. Roentgenol. 182: 227-233 [Abstract] [Full Text]  
• Moore, D. H., Donnelly, J., McGuire, W. P., Almadrones, L., Cella, D. F., Herzog, T. J., Waggoner, S. E. (2003). Limited Access Trial Using Amifostine for Protection Against Cisplatin- and Three-Hour Paclitaxel-Induced Neurotoxicity: A Phase II Study of the Gynecologic Oncology Group. JCO 21: 4207-4213 [Abstract] [Full Text]  
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