OPTIONS FOR PRIMARY CHEMOTHERAPY IN ADVANCED OVARIAN-CANCER - THE EUROPEAN PERSPECTIVE

Primary chemotherapy for ovarian cancer has evolved over the past 30 y ears from the use of single alkylating agent to several combination re gimens. Treatment strategies, however, vary greatly both nationally an d internationally, since no firm results can be derived from available data. Five questions can be identified: (I) Should primary chemothera py consist of single agent or combination? (2) Should it include doxor ubicin? (3) Is cisplatin or carboplatin preferred? (4) Which is the ro le of cisplatin dose intensity? (5) Should it include taxol? Available data from the European experience are discussed. Final considerations include: (1) Platinum combinations are more effective than single age nt platinum when this drug is used at the same dose (now considered lo wer than current standard). (2) CAP offers a survival benefit of 7% at 6 years compared to CP. However, in most trials dose intensity was hi gher in CAP than in CP. (3) Cisplatin and carboplatin are equally effe ctive. (4) There is no survival benefit when doubling the dose intensi ty of cisplatin over 25 mg/m(2)/week. (5) A confirmatory study will he lp define the contribution of Taxol in the first-line treatment of ova rian cancer, when administered at 175 mg/m(2) over a 3-hr infusion in association with cisplatin. (C) 1994 Academic Press, Inc.