Combined weekly carboplatin and paclitaxel as primary treatment of advanced epithelial ovarian carcinoma

Abstract

Objective To evaluate safety and outcome of weekly carboplatin and paclitaxel as the initial postoperative adjuvant chemotherapy for epithelial ovarian carcinoma (EOC) patients. Methods Patients with stage IC-IV epithelial ovarian cancer (EOC) primary peritoneal or tubal carcinoma were enrolled in this phase II study. Intravenous carboplatin (area under the curve 2) and paclitaxel (80 mg/m 2) were administered on days 1, 8, and 15 of a 28-day cycle for 6–8 cycles. Cytoreductive surgery was performed as primary treatment or after 3 cycles of weekly neoadjuvant chemotherapy, followed postoperatively by an additional 3 cycles of chemotherapy. Results Sixty-four women (median age 65 years, range 39.9–82.8) were enrolled. Fifty-six of them (87.6%) were diagnosed with stage III–IV disease. Neutropenia was the most common hematological toxicity: 25% of the subjects had grade 3–4 neutropenia, 34.4% were supported by GCSF and 15.6% received epoetin. The majority (89%) of the patients had grade 1 and only 7.8% had grade 2 alopecia. 7.8% had grade 3 fatigue and 14.1% had grade 2 and 3.1% grade 3 neuropathy, none developed grade 4 neuropathy and only 6.3% had some residual neuropathy at > 6 months after treatment. With a median follow-up of 31.5 months (range 5.9–57.3), estimated median survival was 52.0 months and median progression-free survival 25.74 (8.4–57.3) months (95% CI, 21.2–30.3). Overall and complete response rates were 92.1% and 64.1% respectively. Conclusion Weekly carboplatin and paclitaxel as the initial chemotherapy for EOC is a feasible and well tolerated regimen and should be further evaluated in a larger phase III study.