NEW YORK -- September 24, 2009 -- Women given a more intensive dose-dense regimen of chemotherapy survive longer and have a higher-rate of progression-free survival (PFS), according to a study published online first and in an upcoming edition of The Lancet.
Noriyuki Katsumata, MD, National Cancer Center Hospital, Tokyo, Japan, and colleagues compared a conventional regimen of paclitaxel and carboplatin with a dose-dense weekly regimen in women with advanced ovarian cancer.
The multicentre phase 3 study included patients with advanced epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer. Patients were given 6 cycles of either paclitaxel 180 mg/mē (3 h intravenous infusion) plus carboplatin, given on day 1 of a 21-day cycle (conventional regimen; n = 320), or dose-dense paclitaxel 80 mg/mē (1 h intravenous infusion) given on days 1, 8, and 15, plus carboplatin given on day 1 of a 21-day cycle (dose-dense regimen; n = 317). The primary endpoint was PFS.
Median PFS was longer in the dose-dense treatment group (28 months) than in the conventional treatment group (17 months). Overall survival at 3 years was also higher in the dose dense regimen group (72%) than in the conventional treatment group (65%).
Of the patients, 165 assigned to the dose-dense regimen and 117 assigned to the conventional regimen discontinued treatment early. Reasons for participant dropout were balanced between the groups, apart from withdrawal because of toxicity, which was higher in the dose-dense regimen group than in the conventional regimen group (n = 113 vs n = 69).
Most patients in both groups experienced neutropenia. Severe anaemia was higher in the dose-dense treatment group (69%) than in the conventional treatment group (44%).
The authors said that the survival benefits shown in the dose-dense group are rare in women with advanced ovarian cancer.
"Dose-dense weekly paclitaxel plus carboplatin improved survival compared with the conventional regimen and represents a new treatment option in women with advanced epithelial ovarian cancer," the authors concluded.
SOURCE: The Lancet
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