The Pharmaceutical Journal
Vol 270 No 7255 p882
28 June 2003

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Survival in relapsed ovarian cancer improved with paclitaxel

Women with relapsed ovarian cancer are likely to live longer if they are treated with platinum-based chemotherapy plus paclitaxel (Taxol) than if they receive conventional platinum-based treatment alone (Lancet 2003;361:2099).

This finding comes from research led by the Medical Research Council clinical trials unit, which involved 802 patients with relapsed cancer that was still sensitive to platinum-based treatment.

The researchers say there is no agreement on the best second-line treatment for relapsing disease but argue that their results, which come from two parallel trials, suggest an additive effect of platinum and paclitaxel.

"All women who relapse more than six months after the completion of previous platinum-based chemotherapy should be considered for combination chemotherapy with platinum and paclitaxel," they say.

In the trials, known as ICON4 and AGO-OVAR-2.2, women were randomly assigned to one of two treatment regimens. The researchers found that more women assigned to combination therapy than conventional platinum-based therapy were alive two years after the trial began (57 per cent versus 50 per cent). In addition, both median survival and progression-free survival were longer for patients who received paclitaxel (29 versus 24 months and 13 months versus 10 months, respectively).

Furthermore, combination treatment with paclitaxel was associated with less haematological toxic effects than conventional platinum-based chemotherapy. This result supports previous suggestions that paclitaxel may be myeloprotective, they say.