Combination chemotherapy best option for treating relapsed ovarian cancer

Results of a European study in this week's issue of THE LANCET suggest that combination treatment with paclitaxel and platinum-based chemotherapy could result in a modest but important survival benefit for women with relapsing ovarian cancer compared with women treated with platinum-based chemotherapy alone.

Ovarian cancer is the fourth most common cancer among women and causes over 100,000 deaths worldwide every year. Although treatment has improved over the past three decades (involving surgery and platinum-based chemotherapy), most women relapse and die of the disease within five years. There is currently no first-choice treatment for relapsing ovarian cancer.

Around 800 women with relapsing ovarian cancer (who had initially responded to platinum-based chemotherapy) were enrolled from 119 centres in the UK, Italy, Germany, Norway, and Switzerland. Patients were randomly assigned paclitaxel and platinum chemotherapy or conventional platinum-based chemotherapy.

After three and a half years follow-up, women assigned combination therapy had a modest survival benefit compared to those given platinum chemotherapy alone (the two-year survival rate was 57% in the combination group compared with 50% in the platinum-only group). Women given combination treatment survived for an average of five months more (29 months in total) compared with women given platinum therapy alone. Self-reported quality of life assessments showed no difference between the two groups.

Lead UK investigator Jonathan Ledermann from the Medical Research Council clinical Trials Unit comments: "Our findings show a beneficial effect for paclitaxel in combination with platinum chemotherapy on survival and progression-free survival among patients with platinum-sensitive relapsed ovarian cancer. Paclitaxel was most frequently combined with carboplatin, and the most common conventional platinum-based chemotherapy used was single-agent carboplatin. We believe, therefore, that all women who relapse more than 6 months after the completion of previous platinum-based chemotherapy should be considered for combination chemotherapy with platinum and paclitaxel, even if they received paclitaxel as part of their first-line treatment."

Contact: Dr Jonathan Ledermann, c/o the Medical Research Council Press Office; T) 44-0-20-7637-6011; E) press.office@headoffice.mrc.ac.uk

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