New cytostatic drugs in ovarian cancer

Background Many ovarian cancer patients will after treatment of the recurrence with cisplatin based therapy enter phase I or II studies with new drugs. Lately, some new agents have shown activity. Materials and methods The review is based on phase II studies mainly and focuses on paclitaxel (taxol)....

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Bibliographic Details
Published in:Annals of oncology 1993, Vol.4 (suppl-4), p.S63-S70
Main Authors: Hansen, H.H, Eisenhauer, E. A., Hansen, M., Neijt, J. P., Piccart, M. J., Sessa, C., Thigpen, J. T.
Format: Article
Language:English
Subjects:
Antimetabolites, Antineoplastic - therapeutic use
Antineoplastic Agents - therapeutic use
Clinical Trials, Phase II as Topic
Clinical Trials, Phase III as Topic
Deoxycytidine - analogs & derivatives
Deoxycytidine - therapeutic use
Female
Humans
new drugs
ovarian cancer
Ovarian Neoplasms - drug therapy
Paclitaxel - therapeutic use
phase II
Randomized Controlled Trials as Topic
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Summary:Background Many ovarian cancer patients will after treatment of the recurrence with cisplatin based therapy enter phase I or II studies with new drugs. Lately, some new agents have shown activity. Materials and methods The review is based on phase II studies mainly and focuses on paclitaxel (taxol). Results A Canadian/European study of high (175 mg/ m2) versus low dose (135 mg/m2), and short (3 hours) versus long (24 hours) infusion confirms the reported activity of paclitaxel in previously treated patients. The preliminary overall response rate in 286 evaluable patients is 18.5%. A dose effect exists regarding neuropathy and neutropenia, and a longer infusion duration results in a higher frequency of grade 4 neutropenia. In a phase III study comparing cisplatin 75 mg/m2 plus cyclophosphamide (750 mg/m2) or plus paclitaxel 135 mg/m2 over 24 hours, the paclitaxel-based combination gave a superior response rate (54% versus 33%) and statistically significant longer progression-free interval. The semisynthetic docetaxel (taxotere) gives an overall response rate of 32% (95% confidence interval 23%–43%). Skin toxicity and edema are dose-limiting factors. Gemcita-bine has also shown activity in platinum-resistant patients with an overall response rate of 23% (95% CI 10%–40%). Conclusions The role of new drugs in first-line therapy remains to be seen. Further development of experimental work for screening and evaluation of new agents is needed.
ISSN:0923-7534
1569-8041
DOI:10.1093/annonc/4.suppl_4.S63