Relapsed Ovarian Cancer Responds to Pegylated Liposomal Doxorubicin-Carboplatin

Peggy Peck

June 10, 2004

June 10, 2004 (New Orleans) -- Replacing paclitaxel with pegylated liposomal doxorubicin in a carboplatin chemotherapy regimen for the treatment of women with advanced ovarian cancer in late relapse significantly reduced alopecia and neurotoxicity without affecting survival, according to results presented at the 40th annual meeting of the American Society of Clinical Oncology (ASCO).

"When a woman hears that ovarian cancer has recurred, it can be among the worst moments in her life, because she knows that there is very little that we can do for her," said senior author Eric Pujade-Lauraine, MD, chief of the department of medical oncology at Hopital Hotel Dieu in Paris, France. Moreover, Dr. Pujade-Lauraine said, the adverse effects of standard treatment impair her quality of life.

"What we have done is to make the time she has left better," said lead author Jean-Mark Ferrero, head of medical oncology at Centre Antoine Lacassange in Nice, France.

ASCO president Margaret Tempero, MD, director of clinical sciences and deputy director of the University of California at San Francisco Comprehensive Cancer Center and chief of medical oncology, applauded the effort to develop a treatment that improved quality of life. Questions about quality of life "need to be a companion to clinical trials," she said. "You do have to pay attention to these side effects." Dr. Tempero was not involved in the study.

While patients are often willing to put up a great deal for "even a small benefit in survival," Dr. Tempero said, hair loss is often devastating to patients and neurotoxicity, which limits even the ability to perform simple tasks such as buttoning a shirt, is also debilitating.

The researchers compared the effects of the treatment to those in 392 historical control patients in previously published data. Alopecia in the 105 patients who received the alternative treatment was 12% compared with 86% in the historical controls. The incidence of grade 2 or higher neurotoxicity was 7% vs. 20% in the historical control patients. The overall response rate was 63% vs. 66% and the progression-free interval was 9.4 vs. 12 months in the current study compared with the historical control patients, respectively.

Dr. Ferrero explained that the difference in progression-free interval might be related to the way it was calculated. In the historical comparative study, he said, progression was measured by recurrence of symptoms; in the current study, progression was measured as a rise in CA125 level.

"Typically, a rise in CA125 precedes symptoms by about 1.5 months," Dr. Pujade-Lauraine said. He cautioned, however, that their findings are limited by the use of historical controls. He said a prospective study is being planned.

The study was funded by Schering-Plough.

ASCO 2004 Annual Meeting: Poster 5022. Presented June 7, 2004.

Reviewed by Gary D. Vogin, MD

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