NEW ORLEANSIn women undergoing second-line therapy for advanced
ovarian cancer after failure of a platinum-based regimen, paclitaxel
(Taxol) alone was as effective as epiru-bicin (Ellence) plus
paclitaxel. Valter Torri, MD, coordinator of clinical trials, Mario
Negri Institute, Milan, Italy, presented the research at the American
Society of Clinical Oncology annual meeting.
In the study, which involved 235 patients at 34 centers, all patients
received paclitaxel as a 3-hour IV infusion at 175 mg/m² every
21 days for four to six cycles. In addition, about half the patients
also received epirubicin IV at 80 mg/m², also every 21 days for
four to six cycles. The median number of cycles was four.
Ninety-one paclitaxel recipients and 92 paclitaxel/epirubicin
recipients could be evaluated. Researchers found no significant
differences between the groups. Complete responses occurred in 20.6%
of the paclitaxel patients vs 11.8% of combination-therapy patients.
Partial response rates were 20.6% vs 27.6%, respectively.
Progression-free intervals again were not significantly different,
nor were survival lengths.
Grade 3-4 hematologic toxicities were more common in the combination
therapy group. Neutropenia occurred in 21.6% of combination-therapy
patients vs 9.3% in the single-agent group. Nonhematologic toxicity
rates were similar in both groups.
Despite higher toxicity, the combination of paclitaxel and
epirubicin is not more effective than single-agent paclitaxel in this
subset of patients, Dr. Torri concluded.
He added that despite the acceptable response rate in both arms,
neither treatment had a major impact on time to progression or
survival. Therefore, we need different combination regimens for
this particular subset of patients refractory to platinum-based