The addition of topotecan to carboplatin and paclitaxel as first-line therapy for advanced ovarian cancer; is it possible only with peripheral blood stem cell support?

A phase I study was performed in order to evaluate the tolerability of the combination of fixed doses of carboplatin and paclitaxel and escalated dose s of topotecan as first line chemotherapy for advanced epithelial ovarian c ancer. Three stage III and one stage IV patients entered the study. The dos e limiting toxicity (neutropenia and thrombocytopenia) was reached at the f irst dose level: paclitaxel 175 mg/m2 on day I, carboplatin AUC 5 on day 1 and topotecan 0.5 mg/m2 daily from day I to day 3. We conclude that it is n ot possible to add topotecan to standard regimens of carboplatin and paclit axel without bone marrow support.