In an effort to resolve one of the ongoing controversies in cancer care,
the National Cancer Institute (NCI) has launched the first large national
study of high-dose chemotherapy for ovarian cancer with transplantation
of bone marrow blood stem cells. The new study is expected to answer critical
questions about the use of this intensive therapy in women with advanced
"This trial should help resolve the debate over whether high-dose
chemotherapy is more, equally or less effective compared to conventional
chemotherapy," said Edward Trimble, MD, of the NCI at a meeting of
the Gynecologic Oncology Group held January 17-19 in Denver. "We also
expect the trial to tell us more about the impact of this treatment on
quality of life."
"I am hopeful that this study will lead us to understand more about
the effectiveness of high-dose chemotherapy for advanced ovarian cancer,"
said Connecticut congresswoman Rosa DeLauro. "As a survivor of this
particular form of cancer, I am especially grateful for the work NCI is
doing to increase the survival rate for this deadly disease."
The new study will enroll 275 women with advanced (stage III) ovarian
cancer who still have evidence of disease after undergoing surgery and
one course of chemotherapy. The women will be divided randomly into two
groups. One group will receive high doses of three drugs--carboplatin (Paraplatin),
mitoxantrone (Novantrone), and cyclophosphamide (Cytoxan, Neosar)--with
autologous stem-cell transplantation. The second group will receive paclitaxel
(Taxol) and carboplatin, a combination now widely considered to be an optimal
therapy for this stage of ovarian cancer.
The researchers will compare the two treatments by measuring their effects
on overall and progression-free survival. They will also attempt to assess
any differences in quality of life between women on the two treatments,
including both physical and psychological well-being.
The study will take place at dozens of research centers around the country,
all members of either the Gynecologic Oncology Group or one of several
other cooperative trial groups that NCI supports.
Ovarian cancer is the leading cause of death from gynecologic cancer
in the United States. In 1996, approximately 26,700 new cases were diagnosed
and about 14,800 women died of the disease. Despite its initial responsiveness
to chemotherapy, ovarian cancer has remained difficult to cure. The vast
majority of cases are not diagnosed until they have reached one of the
later stages. Among women with stage III disease, 49% survive for 5 years