Combining bone marrow transplant with high-dose chemotherapy improves
survival rates for women with advanced ovarian cancer, according
to researchers at Loyola University Medical Center, Chicago.
Of 30 women whose cancers failed to respond successfully to prior
chemotherapy treatments and who then underwent the innovative
therapy, 23% remained alive and disease-free after 3 years. Only
one death occurred during treatment.
"This represents a significant success, considering that
until now the long-term prognosis was essentially zero for a woman
who developed recurrent or drug-resistant ovarian cancer,"
said Dr. Patrick Stiff, director of bone marrow transplantation
at Loyola and the principal investigator of the study.
Program paticipants ranged in age from 30 to 64. Each received
high doses of mitoxantrone (Novantrone), carboplatin (Paraplatin),
and cyclophosphamide (Cytoxan, Neosar) after stem cells were first
removed from their bone marrow. Following the high-dose chemotherapy,
the preserved stem cells were reinfused in the patient.
"Right now, we are looking at survival rates of only 10%
to 20% on average for ovarian cancer, when applying conventional
treatments," Stiff indicated. "The use of Taxol may
improve survival somewhat, but not by more than a few percentage
Nearly one-quarter of the study participants, all of whom were
drawn from the population of patients with recurrent or drug-resistant
ovarian cancer, remained disease-free even after 3 years, Stiff
said. In fact, more than 80% of the patients initially experienced
remission of their cancers in response to the therapy; median
survival was 29 months.
"We are undertaking further studies to determine whether
using this same combination of drugs and transplantation can improve
survival rates even more when given to patients at the outset,
before they have developed recurrent or drug-resistant stages
of the disease," Stiff said.
The study represents the second phase of work that Stiff began
in 1989 as the single largest program of its kind in the nation,
according to a spokesperson for Loyola. The early work not only
established the potential effectiveness of the combination therapy
but also provided a profile of the patient who would likely benefit
most from the treatment.
A full report on the study appears in the June issue of Gynecologic