Cisplatin, epirubicin and cyclophosphamide (PEC) in the treatment of advanced ovarian cancer

We report the long-term results of a series of patients affected by advance d epithelial ovarian cancer treated with the PEC combination (cisplatin 60 mg/m(2), epirubicin 60 mg/m2 and cyclophosphamide 750 mg/m(2), all at day 1 , every 21 days). Response was evaluated after three cycles, and treatment continued in responsive patients. A total of 80 patients with a median follow-up of 55 months were studied. F ifty-eight patients with stage III ovarian cancer and 22 patients with stag e IV received PEC as primary treatment (41 patients), or for residual disea se after surgery (37 patients), or for relapsed disease after primary surge ry (2 patients). The overall response rate was 67.5% (20.0% complete respon se, 47.5% partial response), with 22.5% stable disease and 3.7% progressive disease. Median progression free survival was 13.0 months, and median surv ival was 25 months. Grade III-IV toxicity was moderate: leukopenia 20.0% of patients, thrombocytopenia 5.0%, anemia 16.2%. No cardiac toxicity was obs erved. In conclusion, the PEC combination, an anthracycline-containing platinum-ba sed regimen, proved to be effective in advanced ovarian cancer, in terms of response rate and overall survival. The regimen was devoid of significant toxicity and in particular of cardiac toxicity.