PHILADELPHIA--Women with advanced ovarian cancer had 50% longer
survival when they received a first-line regimen combining paclitaxel
(Taxol) and cisplatin (Platinol), says William P. McGuire, MD,
and his colleagues in the Gynecology Oncology Group (GOG).
Median overall survival was 38 months for the paclitaxel combination
vs 24 months for standard cisplatin/cyclophosphamide, he said.
"The results of this trial are extremely significant,"
said Dr. McGuire, professor of medicine, Emory University, and
lead investigator for the study. "It is my strong feeling
that all women with this type of ovarian cancer should be primarily
treated with paclitaxel and cisplatin. This therapy should become
the new standard for advanced ovarian cancer."
The GOG trial involved 386 eligible women with incompletely resected
stage III ovarian cancer or any stage IV ovarian cancer who had
received no previous chemotherapy or radiation for their ovarian
The patients were randomized to a regimen of 75 mg/m² of
cisplatin plus either 750 mg/m² of cyclophosphamide or 135
mg/m² of paclitaxel, as a 24-hour continuous infusion. Both
regimens were given every 3 weeks for a total of six courses.
Women receiving paclitaxel were premedicated with dexamethasone,
diphenhydramine, and a histamine H2 antagonist.
In addition to increased overall survival, patients receiving
paclitaxel had longer periods of progression-free survival--18
months vs 13 months for standard therapy, Dr. McGuire said in
the published report (N Engl J Med 334:1-6, 1996).
Moreover, response rates were higher with paclitaxel. Of 216 women
with measurable tumors, 73% receiving paclitaxel/cisplatin responded
vs 60% in the standard therapy arm. The complete clinical response
rate with paclitaxel/cisplatin was 51% vs 31% for the standard