The Gynecologic Oncology Group experience in ovarian cancer

Trials performed in the past 15 years by the Gynecologic Oncology Group ide ntified as optimal a platinum/taxane combination as the backbone to treat c hemonaive ovarian cancer. Comparison to a triplet adding a third drug to th e backbone is least likely to significantly improve outcome, however, of th e drugs currently available for addition; doxil, etoposide, gemcitabine, an d topotecan; none appears to be any better or worse than was paclitaxel a d ecade ago. An approach more likely to improve outcome would be to incorpora te as many of these "new" drugs as possible using sequential doublets. Some doublets have a better biochemical rationale such as cisplatin and gemcita bine (inhibition of DNA repair) or topotecan and either doxil or etoposide (upregulation of topoisomerase II levels by topotecan followed by a topoiso merase II inhibitor.