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Annals of Oncology Advance Access originally published online on May 31, 2005
Annals of Oncology 2005 16(7):1116-1122; doi:10.1093/annonc/mdi223
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© 2005 European Society for Medical Oncology

Paclitaxel plus carboplatin versus paclitaxel plus alternating carboplatin and cisplatin for initial treatment of advanced ovarian cancer: long-term efficacy results: a Hellenic Cooperative Oncology Group (HeCOG) study

G. Aravantinos1,*, G. Fountzilas2, P. Kosmidis3, M. A. Dimopoulos4, G. P. Stathopoulos5, N. Pavlidis6, D. Bafaloukos7, C. Papadimitriou4, S. Karpathios4, V. Georgoulias9, P. Papakostas8, H. P. Kalofonos10, E. Grimani1 and D. V. Skarlos5

1 ‘Agii Anargiri’ Cancer Hospital, Athens; 2 Aristotle University of Thessaloniki-School of Medicine, Thessaloniki; 3 Hygeia Hospital, Athens; 4 ‘Alexandra’ General Hospital, Athens; 5 ‘Henry Dunant’ Hospital, Athens; 6 University Hospital of Ioannina, Ioannina; 7 ‘Metropolitan’ Hospital, Piraeus; ; 8 ‘Ipokration’ General Hospital, Athens; 9 University Hospital of Herakleion-Crete, Herakleion; 10 University Hospital of Rio-Department of Medicine, Rio-Patras, Greece

Correspondence to: Dr G. Aravantinos, Hellenic Cooperative Oncology Group, Laskaridou 1 & Kifissias, 11524 Athens, Greece. Tel: +30210-6912-520; Fax: +30210-6912-713; Email: hecogaga{at}otenet.gn

Background: We compared the combination plus Carboplatin plus paclitaxel, which is considered the treatment of choice for initial chemotherapy of advanced ovarian cancer (AOC) with a regimen combining alternating carboplatin and cisplatin plus paclitaxel. The two platinum derivatives have been previously combined as they are not totally cross-resistant and as they share no overlapping toxicities.

Patients and methods: Patients with AOC, after the initial cytoreductive surgery were randomized to either 6 courses of paclitaxel at 175 mg/m2 as 3h infusion plus Carboplatin at 7 AUC (Arm A) or Paclitaxel at the same dose plus Carboplatin again at 7 AUC for cycles 1,3,5, while for cycles 2,4,6 Cisplatin at 75 mg/m2 substituted for Carboplatin (Arm B).

Results: 247 patients are analyzed. Significant differences were not found, both in terms of PFS (38 vs 39 months, p=0.95) and overall survival (40.6 vs 38.6 months, p=0.79). There was not also difference in 5-year survival rate (35% vs 39%) or 5-year PFS rate (23% vs 28%). Age >60, PS 2, stage IV disease and presence of residual disease were adversely related to the overall survival.

Conclusion: Both regimens are well tolerated and effective. Alternating cisplatin with carboplatin does not improve the results compared with the standard combination.

Key words: alternating cisplatin with carboplatin, chemotherapy, initial treatment, ovarian cancer


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