A Phase III Randomized Study Comparing Paclitaxel and Cisplatin versus Cyclophosphamide and Cisplatin in Patients with Advanced Ovarian Cancer

Abstract

Aim: To assess progression-free survival (PFS) and overall survival (OS) in patients with advanced epithelial ovarian cancer receiving the combination of cisplatin (75 mg/m² i.v.) and cyclophosphamide (700 mg/m² i.v.) (CP), or the combination of paclitaxel (175 mg/m²) followed by cisplatin (75 mg/m²) (TP). Patients and Methods: One hundred and twenty patients were randomized to receive six cycles of one of the treatments every 3 weeks. If measurable, complete response (CR) or partial response (PR) was determined. Results: There was a significant difference (p<0.05) in the frequency of response (CR+PR) rates between treatment groups, in favor of paclitaxel containing regimen. The median PFS was 9 months for patients in the CP group and 12 months for patients in the TP group (log-rank p=0.215). The median OS were 24 months and 20 months in TP and CP arms, respectively (log-rank p=0.350). Neutropenia and alopecia were more severe with paclitaxel-containing regimen. Conclusion: Although OS and PFS were similar in two arms, TP regimen yielded superior response rates relative to CP, with an acceptable toxicity profile. Therefore, the TP regimen remains the preferred initial treatment option.