This study compared two chemotherapy regimens for women with advanced ovarian cancer who had had optimal surgery: one with cisplatin and the other with carboplatin, both given with paclitaxel. The results showed that the carboplatin regimen works no less well, has fewer side effects and is easier to give.
Initial treatment of advanced ovarian cancer
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Carboplatin | 300 mg/m² (or formula dosing) | IV, over 15 minutes or more | Day 1 |
| Cyclophosphamide | 600 mg/m² | IV | Day 1 |
Today, initial treatment of ovarian cancer usually uses the combination with paclitaxel (next row).
On the page “Carboplatin (Paraplatin)” · Standard dosing and combination regimens
Previously untreated advanced ovarian cancer
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Option A | |||
| Paclitaxel | 175 mg/m² | IV infusion over 3 hours | Day 1, before cisplatin |
| Cisplatin | 75 mg/m² | IV | Day 1 |
| Option B | |||
| Paclitaxel | 135 mg/m² | IV infusion over 24 hours | Day 1, before cisplatin |
| Cisplatin | 75 mg/m² | IV | Day 1 |
The choice between the two regimens is based on their different toxicities. In practice, carboplatin now usually replaces cisplatin (GOG-158).
On the page “Paclitaxel (Taxol)” · Standard doses (FDA label)
Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.
Cisplatin 75 mg/m² with a 24-hour infusion of paclitaxel 135 mg/m².
Carboplatin at an area under the curve (AUC) of 7.5 IV with paclitaxel 175 mg/m² over 3 hours.
Source of the regimen details: Abstract of the paper (the number of cycles is not given in the abstract)
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Patients with advanced ovarian cancer (stage 3 epithelial ovarian cancer) with no residual mass larger than 1.0 cm after surgery (optimal resection).
The aim of the study was to assess the non-inferiority of carboplatin + paclitaxel compared with cisplatin + paclitaxel. The abstract reports progression-free survival, overall survival and toxicities.
Gastrointestinal, renal and metabolic toxicities and grade 4 leucopenia were significantly more common in the cisplatin + paclitaxel group. Grade 2 or higher thrombocytopenia was more common in the carboplatin + paclitaxel group. Neurotoxicity was similar with the two regimens.
Based on the abstract, carboplatin plus paclitaxel, with less toxicity, easier administration and non-inferior efficacy, is an acceptable alternative to cisplatin plus paclitaxel in optimally resected advanced ovarian cancer. The current place of this regimen in clinical guidelines should be checked in up-to-date sources.
Based on the abstract, the 95% CI for the relative risk of progression (0.75–1.03) and of death (0.70–1.02) includes 1, so a significant superiority of carboplatin was not shown and the result only demonstrates non-inferiority. The two groups also differed in the paclitaxel infusion schedule (24 hours versus 3 hours). Other limitations are not reported in the abstract.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.
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