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International study suggests carboplatin could be first-line chemotherapy drug for ovarian cancer

N. B. Please note that if you are outside North America the embargo date for all Lancet press material is 0001hours UK time 16 August 2002

Lancet

Results of an international study in this week's issue of THE LANCET suggest that the drug carboplatin could become a first-line chemotherapeutic agent for the treatment of ovarian cancer. Carboplatin was found to be less toxic, although it had no overall survival benefit, compared with other drugs assessed in the study.

Ovarian cancer is the sixth most common cancer of women worldwide; around 165,000 people are diagnosed with the disease every year, and five-year survival for women with advanced disease is only around 30%. Treatment involves surgery (eg. total hysterectomy or removal of the ovaries) and postoperative chemotherapy.

Previous research has shown that both combinations of the chemotherapeutic drugs cyclophosphamide, doxorubicin, and cisplatin ( known as CAP) and use of carboplatin produce similar survival and progression-free survival rates. More recently, the taxane paclitaxel combined with carboplatin has become a widely accepted treatment for the disease. The International Collaborative Ovarian Neoplasm (ICON) Collaborators, led by Peter Harper, consultant medical oncologist at Guy's Hospital in London, and Nicoletta Colombo, Associate Professor in Obstetrics and Gynaecology at the European Institute of Oncology in Milan, Italy, aimed to compare the safety and efficacy of paclitaxel plus carboplatin with a control of either CAP or carboplatin alone. The trial was coordinated by the MRC Clinical Trials Unit, London, UK.

2074 women with ovarian cancer from 130 centres in eight countries were randomly assigned paclitaxel plus carboplatin or control, the control (CAP or single-agent carboplatin) being chosen by the patients' physician before randomisation. Average follow-up was just over four years; although the average survival (around three years) and average time to disease recurrence (around a year and a half) among all women. Those given paclitaxel plus carboplatin had more serious side effects such as alopecia (hair loss), fever, and sensory neuropathy (loss of sensation in the skin) than other treatments.

Peter Harper comments: "The results of ICON3 suggest that, up to 5 years from treatment, single-agent carboplatin, CAP, and paclitaxel plus carboplatin are all safe and show similar effectiveness as first-line treatments for women requiring chemotherapy for ovarian cancer. Of these three treatments, carboplatin might be regarded as the preferred treatment because of its better toxicity profile."

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Contact: MRC Press Office, 20 Park Crescent, London W1B 1AL, UK; T) +44 (0)20 7637 6011; E) press.office@headoffice.mrc.ac.uk

Professor Martin HN Tattersall, Department of Cancer Medicine, University of Sydney, Blackburn Building (D06), NSW 2006, Australia; T) +61 2 9660 7362; F) +61 2 9351 4317; E) mtatt@med.usyd.edu.au

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