Cis-platinum in combination with adriamycin and cyclophosphamide (PAC) in advanced ovarian cancer

C. Mangioni, C. Sessa, G. Bolis

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Between February 1978 and December 1980, 59 previously untreated stage III-IV epithelial ovarian cancer evaluable patients were treated with Cis-platinum (P) (50 mg/m2 i.v. day 1) in combination with Adriamycin (A) (50 mg/m2 i.v. day 1) and Cyclophosphamide (C) (70 mg/m2 p.o. days 1→14). →4). Each course was repeated every 4 weeks. When the limiting dose of A was reached (450 mg/m2) complete reponders continued treatment with C only (70 mg/m2 p.o. daily). A second-look operation with debulky surgery was performed in 16 of the 42 stage III late patients after a median number of 5 cycles. The surgically CR 33%, with an overall response rate (CR + PR) of 64%. The median survival of CR was 22.5 months, significantly longer than that of partial responders (11+ months) and non-responders (9+ months). Regarding toxicity, all patients vomited, starting about 1-2 h after P. perfusion instead of metoclopramide (0.2 mg/Kg). One patient stopped the therapy after 2 cycles of PAC because of atrial fibrillation. One patient died two days after the first cycle from neoplastic pulmonary embolism. Two sudden deaths were observed after the first cycle of therapy in previously untreated patients. They had apparent normal liver, kidney and heart function and no electrolyte imbalance was observed before death. Autopsy did not clarify the reason for these deaths. In conclusion PAC appears to be very effective in previously untreated advanced ovarian cancer, and also gives some chance of response in alkylator-refractory patients.

Original languageEnglish
Pages (from-to)153-158
Number of pages6
Issue number2-3
Publication statusPublished - 1982

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)


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