Carboplatin, doxorubicin, and cyclophosphamide versus cisplatin, doxorubicin, and cyclophosphamide: A randomized trial in stage III-IV epithelial ovarian carcinoma

P. F. Conte, M. Bruzzone, F. Carnino, S. Chiara, M. Donadio, V. Facchini, P. Fioretti, G. Foglia, A. Gadducci, L. Gallo, G. Giaccone, E. Guercio, L. Iskra, N. Janssen, M. P. Maresi, G. Parodi, N. Ragni, R. Rosso, A. Rubagotti, S. RugiatiA. Storace, S. Venturini, G. Pescetto

Research output: Contribution to journalArticlepeer-review

Abstract

One hundred sixty-four patients with stage III-IV epithelial ovarian carcinoma were randomized to receive cisplatin (CDDP) 50 mg/mq, doxorubicin 45 mg/mq, and cyclophosphamide 600 mg/mq (PAC) or carboplatin 200 mg/mq, doxorubicin 45 mg/m2, and cyclophosphamide 600 mg/mq (CAC). To administer equitoxic doses at each cycle, the drug dosages were adjusted according to the hematologic toxicities experienced after the previous course; 44.7% of CAC and 21.1% of PAC patients required a dosage reduction at the second course (P = .002). Neither CAC nor PAC caused any clinically relevant neuro-nephrotoxicity; however, CDDP was administered with hydration and forced diuresis, while carboplatin was administered by rapid intravenous (IV) infusion. After six cycles, re-sponse rates were superimposable: 62.5% and 66.6% for CAC and PAC, respectively; pathologic complete responses (pCRs) were 16.7% for CAC and 23.2% for PAC; among patients with more than 2 cm residual disease, PAC induced more pCRs than CAC (eight of 52 or 15.4% v one of 42 or 2.4%, P = .07). Median survivals and progression-free survivals (PFSs) were 22.6 and 13.2 months for PAC, and 23.1 and 15.5 months for CAC, respectively; these differences are not significant. In conclusion, this trial demonstrates that equitoxic doses of PAC or CAC result in a similar response rate, PFS, and survival.

Original languageEnglish
Pages (from-to)658-663
Number of pages6
JournalJournal of Clinical Oncology
Volume9
Issue number4
Publication statusPublished - 1991

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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