Dose-dense treatment improved survival, but too toxic for some: study
SUNDAY, Sept. 20 (HealthDay News) -- Dose-dense chemotherapy improves survival in women with advanced ovarian cancer, Japanese researchers say.
Currently, paclitaxel and carboplatin given every three weeks is considered standard first-line chemotherapy for advanced epithelial ovarian cancer. However, dose-dense weekly treatment with paclitaxel is seen as a way to increase progression-free and overall survival in these patients, according to the new study findings.
This phase 3 study of 637 women compared the two approaches. The participants had advanced epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer.
The 320 patients in the conventional regimen group received six cycles of paclitaxel (180 milligrams per meter squared; three-hour intravenous infusion). The 317 patients in the dose-dense group received paclitaxel (80 milligrams per meter squared; one-hour intravenous infusion) on days one, eight and 15. Both groups received carboplatin on day one of a 21-day cycle.
The patients in the dose-dense group had longer median progression-free survival than those in the standard treatment group (28 months versus 17 months), and longer overall survival at three years (72 percent versus 65 percent). This means that women in the dose-dense group had a 29 percent lower risk of cancer progression and a 25 percent lower risk of death, the authors explained.
Toxicity forced 113 patients in the dose-dense group and 69 patients in the conventional therapy group to stop treatment, the researchers noted. Severe anemia occurred in 214 patients (69 percent) in the dose-dense group and in 137 (44 percent) of the standard therapy group.
The survival benefits seen in the dose-dense group are rare in patients with advanced ovarian cancer, and this regimen offers a new treatment option for women with advanced epithelial ovarian cancer, concluded Dr. Noriyuki Katsumata, of the National Cancer Center Hospital in Tokyo, and colleagues.
The study, published in an upcoming print issue of The Lancet, was released online Sunday to coincide with the European Cancer Organization meeting held Sept. 20 to 24 in Berlin.
"The use of such dose-dense therapy should be decided on an individual basis together with other options for women with advanced-stage ovarian cancer," Dr. Michael A. Bookman, of the Arizona Cancer Center in Tucson, wrote in an accompanying commentary in The Lancet.
The U.S. National Cancer Institute has more about ovarian cancer.
-- Robert Preidt
SOURCE: The Lancet, news release, Sept. 19, 2009
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