Clinical Medicine Journal
Articles Information
Clinical Medicine Journal, Vol.1, No.3, Aug. 2015, Pub. Date: May 26, 2015
The Current Situation of Dose-Dense Chemotherapy for Ovarian Carcinoma
Pages: 74-79 Views: 2562 Downloads: 1408
[01] Derya Kilic Sakarya, Department of Obstetrics and Gynecology, Konya Training and Research Hospital, Konya, Turkey.
[02] Mehmet Hakan Yetimalar, Department of Obstetrics and Gynecology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
Ovarian cancer is the leading cause of death from gynecological malignancies. Despite all the years of research, high relapse rates after the standard front-line treatment for advanced disease could not be reduced. Alternative schedules, dosage and agents are under investigation to achive better efficacy and tolerability. The concept of ‘dose-dense therapy’ in which the cumulative drug dose remains constant, but the same amount of drug is administered over a shorter period is promising with an acceptable toxicity profile. The Japanese trial of JGOG with advanced epithelial ovarian cancer showed promise in terms of improvement in survival rates by dose dense weekly paclitaxel and carboplatin. The results of the study had encouraged investigation on dose-dense therapy. Although the preliminary data of the latter studies has not been that much confirmatory forthcoming data will illuminate to validate avaible data. In this review, we aim to provide an update on the avaible data and review the role of dose-dense therapy in the treatment of ovarian cancer.
Carboplatin, Dose-Dense Chemotherapy, Ovarian Cancer, Paclitaxel
[01] Liu J and Matulonis UA: New advances in ovarian cancer. Oncology (Williston Park) 24: 721–728, 2010.
[02] Seidman AD, Berry D, Cirrincione C, Harris L, Muss H, MarcomPK, Gipson G, Burstein H, Lake D, Shapiro CL, Ungaro P, Norton L, Winer E and Hudis C: Randomized phase III trial of weekly compared with every-3-weeks paclitaxel for metastatic breast cancer, with trastuzumab for all HER-2 overexpressors and random assignment to trastuzumab or not in HER-2 nonoverexpressors: final results of Cancer and Leukemia Group B protocol 9840. J ClinOncol 2610: 1642–1649, 2008.
[03] SparanoJA, Wang M, Martino S, Jones V, Perez EA, Saphner T, Wolff AC, Sledge GWJr, Wood WC and Davidson NE: Weekly paclitaxel in the adjuvant treatment of breast cancer. N Engl J Med 358: 1663–1671, 2008.
[04] McGuire WP, Hoskins WJ, Brady MF, Homesley HD, CreasmanWT, Berman ML, Ball H, BerekJS and Woodward J: Assessment of dose-intensive therapy in suboptimallydebulked ovarian cancer: a Gynecologic Oncology Group study. J ClinOncol 13: 1589-1599, 1995.
[05] Fruscio R, Garbi A, Parma G, Lissoni AA, Garavaglia D, Bonazzi CM, Dell'anna T, Mangioni C, Milani R and Colombo N: Randomized phase III clinical trial evaluating weekly cisplatin for advanced epithelial ovarian cancer. J Natl Cancer Inst 103: 347-351, 2011.
[06] OzolsRF, Ostchega Y, Myers CE and RC Young: High-dose cisplatin in hypertonic saline in refractory ovarian cancer. Journal of Clinical Oncology 1246-1250, 1985.
[07] Katsumata N, Yasuda M, Takahashi F, Isonishi S, Jobo T, Aoki D, Tsuda H, Sugiyama T, Kodama S, Kimura E, Ochiai K and Noda K: Dose-dense paclitaxel once a week in combination with carboplatin every 3 weeks for advanced ovarian cancer: a phase 3, open-label, randomised controlled trial. The Lancet 374: 1331-1338, 2009.
[08] Katsumata N, Yasuda M, Isonishi S, Takahashi F, Michimae H, Kimura E, Aoki D, Jobo T, Kodama S, Terauchi F, Sugiyama T and Ochiai K: Long-term results of dose-dense paclitaxel and carboplatin versus conventional paclitaxel and carboplatin for treatment of advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer (JGOG 3016): a randomised, controlled, open-label trial. Lancet Oncol 14: 1020-1026, 2013.
[09] Harano K, Terauchi F, Katsumata N, Takahashi F, Yasuda M, Takakura S, Takano M, Yamamoto Y, Sugiyama T: Quality-of-life outcomes from a randomized phase III trial of dose-dense weekly paclitaxel and carboplatin compared with conventional paclitaxel and carboplatin as a first-line treatment for stage II–IV ovarian cancer: Japanese Gynecologic Oncology Group Trial (JGOG 3016). Annals of Oncology 25: 251–257, 2014.
[10] Stiff P, Antman K, Broun E, et al: Bone marrow transplantation for ovarian carcinoma in the United States: A survey of active programs. Proceedings of the 6th International Autologous Bone Marrow Transplantation Symposium, pp 1-9, 1992.
[11] Bengala C, Guarneri V, Ledermann J, Rosti G, Wandt H, Lotz JP, Cure JH, Orlandini C, Ferrante P, Conte PF, Demirer T; EBMT Solid Tumor Working Party. High-dose chemotherapy with autologous haemopoietic support for advanced ovarian cancer in first complete remission: retrospective analysis fromthe Solid Tumour Registry of the European Group for Blood and Marrow Transplantation (EBMT).Bone Marrow Transplant 36: 25-31, 2005.
[12] A-Hoekstra AV, HurteauJA, Kirschner CV, Rodriguez GC. Thecombination of monthly carboplatin and weekly paclitaxel ishighly active for the treatment of recurrent ovarian cancer.GynecolOncol 115: 377–381, 2009.
[13] Kumar S, Mahdi H, Bryant C, Shah JP, Garg G, Munkarah A. Clinical trials and progress with paclitaxel in ovarian cancer. Int J Womens Health 2: 411–427, 2010.
[14] Cadron I, Leunen K, Amant F, Van Gorp T, Neven P, Vergote I. The ‘Leuven’ dose-dense paclitaxel/carboplatin regimen in patients with recurrent ovarian cancer. GynecolOncol 106: 354–361, 2007.
[15] Sharma R, Graham J, Mitchell H, Brooks A, Blagden S, Gabra H. Extended weekly dose-dense paclitaxel/carboplatin is feasible and active in heavily pre-treated platinum resistant recurrent ovarian cancer. Br J Cancer 100: 707–712, 2009.
[16] van der Burg ME, van der Gaast A, Vergote I, BurgerCW, van Doorn HC, de Wit R, et al. What is the role of dose-dense therapy? Int J Gynecol Cancer 15: 233–240, 2005.
[17] van der Burg ME, Vergote I, Onstenk W, Boere IA, Leunen K, van Montfort CA, et al. Long-term results of weekly paclitaxel carboplatin induction therapy: an effective and well-tolerated treatment in patients with platinum-resistant ovarian cancer. Eur J Cancer 49: 1254–1263, 2013.
[18] Shawky H, Tawfik H, Hewidy M. Weeklydose-densepaclitaxel and carboplatin in recurrent ovarian carcinoma: a phase II trial. J Egypt NatlCancInst 26:139-245, 2014.
[19] Pignata S, Scambia G, Lauria R, Raspagliesi F, PaniciPB, Cormio G, Katsaros D, Sorio R, Cavazzini G, Ferrandina G, Breda E, Murgia V, Sacco G, Sierra NMA, Pisano C, Salutari V, Weber BE, Pujade-Lauraine E, Gallo C and Perrone F: A randomized multicenter phase III study comparing weekly versus every 3 weeks carboplatin (C) plus paclitaxel (P) in patients with advanced ovarian cancer (AOC): MITO-7—European Network of Gynaecological Oncological Trial Groups (ENGOT-ov-10) and Gynecologic Cancer Intergroup (GCIG) trial. J ClinOncol 31 suppl: abstract LBA5501, ASCO Annual Meeting, 2013.
[20] Pignata S, Scambia G, Katsaros D, Gallo C, Pujade-Lauraine E, De Placido S, Bologna A, Weber B, Raspagliesi F, PaniciPB, Cormio G, Sorio R, Cavazzini MG, Ferrandina G, Breda E, Murgia V, Sacco C, Cinieri S, Salutari V, Ricci C, Pisano C, Greggi S, Lauria R, Lorusso D, Marchetti C, Selvaggi L, Signoriello S, Piccirillo MC, Di Maio M, Perrone F; Multicentre Italian Trials in Ovarian cancer (MITO-7); Grouped'InvestigateursNationaux pour l'Etude des Cancers Ovariens et du sein (GINECO); Mario NegriGynecologic Oncology (MaNGO); European Network of Gynaecological Oncological Trial Groups (ENGOT-OV-10); Gynecologic Cancer InterGroup (GCIG) Investigators: Carboplatin plus paclitaxel once a week versus every 3 weeks in patients with advanced ovarian cancer (MITO-7): a randomised, multicentre, open-label, phase 3 trial. Lancet Oncol 15: 396-405, 2014.
[21] Chan J, Brady M, Penson R, Monk B, Boente M, Walker J, Davidson S, DiSilvestro P, O'Malley D, Morgan M, Pearl M, De Geest K and Michael H: Phase III trial of every-3-weeks paclitaxel versus dose dense weekly paclitaxel with carboplatin +/- bevacizumab in epithelial ovarian, peritoneal, fallopian tube cancer: GOG 262 (NCT0116712). Oral presentation at the European Society of Gynecological Oncology Annual Meeting, 2013.
[22] Bocci G, Di Paolo A and Danesi R: The pharmacological bases of the antiangiogenic activity of paclitaxel. Angiogenesis 16: 481–492, 2013.
[23] Paclitaxel and Carboplatin With or Without Bevacizumab in Treating Patients With Stage II, Stage III, or Stage IV Ovarian Epithelial Cancer, Primary Peritoneal Cancer, or Fallopian Tube Cancer (GOG 262) (trial registration: NCT01167712). Available from: URL:
[24] Weekly Chemotherapy in Ovarian Cancer. International Collaborative Ovarian Neoplasm trial 8 (ICON 8). Available from: URL:
[25] NCCN guidelines for treatment of cancer by ovarian cancer. Available from: URL:
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