Weekly vs every-3-week paclitaxel and carboplatin for ovarian cancer
February 25, 2016
Does administration of paclitaxel weekly improve survival over q3 week dosing?
PDSpaclitaxel 175mg/m2 over 3 hrs carboplatin AUC 6every 21 days for 6 cyclesbevacizumab allowed 15mg/kg every 21 days beginning with cycle 2NACT with IDS after cycle 3 also allowed
PDSpaclitaxel 80mg/m2 over 1 hr day 1, 8, and 15carboplatin AUC 6 every 21 daysfor 6 cyclesbevacizumab allowed 15mg/kg every 21 days beginning with cycle 2NACT with IDS after cycle 3 also allowed
PDS
stage II - IV ovarian cancer (first stage III PDS suboptimal only but then optimal and stage II added as well once GOG 252 closed)US, Canada, South Korea
unfit for treatment
q3 weeks (n=346) vs dose dense (n=346):84% received bevacizumab13% ahd NACT/IDSmedian f/u: 28 mosoverall PFS: 14.0 vs 14.7 mos (NS)patients without bevacizumab PFS: 10.3 vs 14.2 mos (SS)patient with bevacizumab PFS: 14.7 vs 14.9 mos (NS)grade 3/4 anemia: 16% vs 36% (SS)grade 2-4 neuropathy: 18% vs 26% (SS)
dose dense paclitaxel administration did not prolong PFS in women with ovarian cancer and led to higher complication rates