Dose-dense therapy is of benefit in primary treatment of ovarian cancer? In favor

Abstract

Paclitaxel and carboplatin given every 3 weeks is the current standard treatment in first-line chemotherapy regimens for ovarian cancer. The concept of ‘dose-dense therapy’ is based on the hypothesis that a shortening interval of the doses of cytotoxic agents will be more effective for tumor-cell kill. Recently published phase III trials in breast cancer have shown that dose-dense weekly paclitaxel improves response and survival. The Japanese Gynecologic Oncology Group reported a phase III study comparing the conventional 3-weekly paclitaxel and carboplatin schedule versus dose-dense weekly paclitaxel and 3-weekly carboplatin for advanced epithelial ovarian cancer, fallopian tube cancer or primary peritoneal cancer. The progression-free survival, as the primary endpoint of this study, was significantly prolonged with the dose-dense treatment [28 versus 17.2 months; hazard ratio (HR): 0.71; 95% confidence interval (CI): 0.58–0.88; P=0.0015], as was the overall survival at 3 years (72.1% versus 65.1%; HR 0.75; 95% CI: 0.57–0.98; P=0.03). Dose-dense weekly paclitaxel plus carboplatin represents a new treatment option in women with advanced epithelial ovarian cancer.