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Advanced Ovarian Cancer and Paclitaxel–Cisplatin Therapy

A previous randomized trial conducted by the Gynecologic Oncology Group in the United States showed a better outcome for patients with advanced ovarian cancer on a paclitaxel–cisplatin regimen compared with those on a standard cyclophosphamide–cisplatin regimen. Before considering the paclitaxel–cisplatin regimen as a new “standard,” Piccart et al. (p. 699) planned a confirmatory phase III trial. This new trial observed a higher overall clinical response rate (58.4% versus 44.7%) and a higher complete clinical remission rate (40.7% versus 27.3%) in the paclitaxel group compared with the cyclophosphamide group. At a median follow-up of 38.5 months, longer progression-free survival and longer overall survival were observed with the paclitaxel regimen. The investigators recommend paclitaxel–cisplatin as the new standard regimen for the treatment of patients with advanced ovarian cancer.

In an editorial, McGuire (p. 674) echoes the conclusions of Piccart et al. He points out that the design and accrual of this multinational trial allowed for efficient use of patient resources and provided generalizable results. He suggests that this strategy be adopted in future trial designs.