ICON2: Randomised trial of single-agent carboplatin against three-drug combination of CAP (cyclophosphamide, doxorubicin, and cisplatin) in women with ovarian cancer

M. K B Parmar, V. Torri, A. Bonaventura, C. Bonazzi, N. Colombo, J. F. Delaloye, S. Marsoni, C. Mangioni, J. Sandercock, C. Sessa, C. Williams, A. Tinazzi, M. Flann, K. Geiser, N. Scorpiglione

Research output: Contribution to journalArticle

Abstract

Background: A series of meta-analyses of randomised controlled trials raised the question of whether the three-drug combination of CAP (cyclophosphamide, doxorubicin, and cisplatin) was more or less effective than optimal-dose single-agent carboplatin for women with advanced ovarian cancer. Methods: We carried out an international, multicentre, randomised trial to compare CAP with single-agent carboplatin in women with ovarian cancer requiring chemotherapy. 1526 patients were entered from 132 centres in nine countries. Analyses were by intention to treat. Findings: 728 patients have died (368/766 allocated CAP vs 360/760 allocated carboplatin) and the survival curves show no evidence of a difference between CAP and carboplatin (hazard ratio 1.00 [95% CI 0.86-1.16]; p = 0.98). The results indicate a median survival of 33 months and a 2-year survival of 60% for both groups. We found no evidence that CAP or carboplatin were more or less effective in different subgroups defined by age, stage, residual disease, differentiation, histology, and coordinating centre. CAP was substantially more toxic than carboplatin, causing more alopecia, leucopenia, and nausea. More thrombocytopenia occurred with carboplatin. Interpretation: Single-agent carboplatin, with the dose calculated by the area-under-the-curve method, is a safe, effective, and appropriate standard of treatment for women with advanced ovarian cancer.

Original languageEnglish
Pages (from-to)1571-1576
Number of pages6
JournalLancet
Volume352
Issue number9140
Publication statusPublished - Nov 14 1998

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Carboplatin
Drug Combinations
Ovarian Neoplasms
Doxorubicin
Cyclophosphamide
Cisplatin
Survival
Intention to Treat Analysis
Poisons
Alopecia
Leukopenia
Thrombocytopenia
Nausea
Multicenter Studies
Area Under Curve
Meta-Analysis
Histology
Randomized Controlled Trials
Drug Therapy

ASJC Scopus subject areas

  • Medicine(all)

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ICON2 : Randomised trial of single-agent carboplatin against three-drug combination of CAP (cyclophosphamide, doxorubicin, and cisplatin) in women with ovarian cancer. / Parmar, M. K B; Torri, V.; Bonaventura, A.; Bonazzi, C.; Colombo, N.; Delaloye, J. F.; Marsoni, S.; Mangioni, C.; Sandercock, J.; Sessa, C.; Williams, C.; Tinazzi, A.; Flann, M.; Geiser, K.; Scorpiglione, N.

In: Lancet, Vol. 352, No. 9140, 14.11.1998, p. 1571-1576.

Research output: Contribution to journalArticle

Parmar, MKB, Torri, V, Bonaventura, A, Bonazzi, C, Colombo, N, Delaloye, JF, Marsoni, S, Mangioni, C, Sandercock, J, Sessa, C, Williams, C, Tinazzi, A, Flann, M, Geiser, K & Scorpiglione, N 1998, 'ICON2: Randomised trial of single-agent carboplatin against three-drug combination of CAP (cyclophosphamide, doxorubicin, and cisplatin) in women with ovarian cancer', Lancet, vol. 352, no. 9140, pp. 1571-1576.
Parmar, M. K B ; Torri, V. ; Bonaventura, A. ; Bonazzi, C. ; Colombo, N. ; Delaloye, J. F. ; Marsoni, S. ; Mangioni, C. ; Sandercock, J. ; Sessa, C. ; Williams, C. ; Tinazzi, A. ; Flann, M. ; Geiser, K. ; Scorpiglione, N. / ICON2 : Randomised trial of single-agent carboplatin against three-drug combination of CAP (cyclophosphamide, doxorubicin, and cisplatin) in women with ovarian cancer. In: Lancet. 1998 ; Vol. 352, No. 9140. pp. 1571-1576.
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abstract = "Background: A series of meta-analyses of randomised controlled trials raised the question of whether the three-drug combination of CAP (cyclophosphamide, doxorubicin, and cisplatin) was more or less effective than optimal-dose single-agent carboplatin for women with advanced ovarian cancer. Methods: We carried out an international, multicentre, randomised trial to compare CAP with single-agent carboplatin in women with ovarian cancer requiring chemotherapy. 1526 patients were entered from 132 centres in nine countries. Analyses were by intention to treat. Findings: 728 patients have died (368/766 allocated CAP vs 360/760 allocated carboplatin) and the survival curves show no evidence of a difference between CAP and carboplatin (hazard ratio 1.00 [95{\%} CI 0.86-1.16]; p = 0.98). The results indicate a median survival of 33 months and a 2-year survival of 60{\%} for both groups. We found no evidence that CAP or carboplatin were more or less effective in different subgroups defined by age, stage, residual disease, differentiation, histology, and coordinating centre. CAP was substantially more toxic than carboplatin, causing more alopecia, leucopenia, and nausea. More thrombocytopenia occurred with carboplatin. Interpretation: Single-agent carboplatin, with the dose calculated by the area-under-the-curve method, is a safe, effective, and appropriate standard of treatment for women with advanced ovarian cancer.",
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T2 - Randomised trial of single-agent carboplatin against three-drug combination of CAP (cyclophosphamide, doxorubicin, and cisplatin) in women with ovarian cancer

AU - Parmar, M. K B

AU - Torri, V.

AU - Bonaventura, A.

AU - Bonazzi, C.

AU - Colombo, N.

AU - Delaloye, J. F.

AU - Marsoni, S.

AU - Mangioni, C.

AU - Sandercock, J.

AU - Sessa, C.

AU - Williams, C.

AU - Tinazzi, A.

AU - Flann, M.

AU - Geiser, K.

AU - Scorpiglione, N.

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N2 - Background: A series of meta-analyses of randomised controlled trials raised the question of whether the three-drug combination of CAP (cyclophosphamide, doxorubicin, and cisplatin) was more or less effective than optimal-dose single-agent carboplatin for women with advanced ovarian cancer. Methods: We carried out an international, multicentre, randomised trial to compare CAP with single-agent carboplatin in women with ovarian cancer requiring chemotherapy. 1526 patients were entered from 132 centres in nine countries. Analyses were by intention to treat. Findings: 728 patients have died (368/766 allocated CAP vs 360/760 allocated carboplatin) and the survival curves show no evidence of a difference between CAP and carboplatin (hazard ratio 1.00 [95% CI 0.86-1.16]; p = 0.98). The results indicate a median survival of 33 months and a 2-year survival of 60% for both groups. We found no evidence that CAP or carboplatin were more or less effective in different subgroups defined by age, stage, residual disease, differentiation, histology, and coordinating centre. CAP was substantially more toxic than carboplatin, causing more alopecia, leucopenia, and nausea. More thrombocytopenia occurred with carboplatin. Interpretation: Single-agent carboplatin, with the dose calculated by the area-under-the-curve method, is a safe, effective, and appropriate standard of treatment for women with advanced ovarian cancer.

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