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Carboplatin and Paclitaxel (Taxol(R)) for the Treatment of Advanced Ovarian-Cancer
International Journal of Gynecological Cancer. 1994 Nov-Dec;4 :13-17
AbstractThe combination of cisplatin with the alkylating agent cyclophosphamide has been the standard treatment regimen following initial cytoreductive surgery for patients with advanced ovarian carcinoma. However, dose-related toxicities have limited the use of cisplatin. Carboplatin, a cisplatin analog, shares the efficacy of cisplatin but not its dose- limiting toxicities. The principal toxicity associated with carboplatin is thrombocytopenia. It has, therefore, replaced cisplatin in the standard regimen with cyclophosphamide. The antimitotic agent paclitaxel (Taxol(R)) is active against advanced ovarian cancer and has been studied as an alternative to cyclophosphamide in the standard combination regimen. Its primary toxicities are neurotoxicity and neutropenia. When given in combination with cisplatin, paclitaxel was associated with a significantly higher response rate than a cisplatin- cyclophosphamide combination but was not associated with significant non-hematologic toxicity (i.e. neuropathy). Studies of a carboplatin-paclitaxel combination suggest that the regimen is effective without significant increases in myelosuppression. This may be due in part to the earlier neutrophil nadir observed with paclitaxel and to carboplatin dose individualization based on renal function and target area under the carboplatin plasma concentration-time curve. Ongoing studies are evaluating the clinical usefulness of dose intensity for carboplatin and paclitaxel, the maximum tolerated dose of each agent in combination, and the optimum infusion regimen for paclitaxel. Findings from these studies may lead to a new standard treatment regimen for advanced ovarian cancer.
NotesEnglish Article 1 PV849 INT J GYNECOL CANCER