Paclitaxel Alone as Effective as Paclitaxel/Epirubicin in Patients With Platinum-Resistant Ovarian Cancer

NEW ORLEANS—In 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 therapy.”