Gemcitabine, platinum, and paclitaxel regimens in patients with advanced ovarian carcinoma

In advanced ovarian cancer, gemcitabine is a candidate for combination chemotherapy due to its unique mechanism of action, favorable toxicity profile, and proven activity. Gemcitabine, paclitaxel, and platinum have demonstrated a response rate of 100% in patients with relapsed ovarian cancer. The median time to progression was 10 months and the median survival was more than 27 months. Two trials with gemcitabine, paclitaxel, and carboplatin in previously untreated patients, including 24 and 13 evaluable patients, respectively, have both demonstrated 100% response rates. A complete remission (CR) rate of 60% has been described in one trial, and the median time to progression in this trial was 16 months. The median survival has not been reached but is more than 30 months. In conclusion, gemcitabine, paclitaxel, and carboplatin is a very active combination in previously untreated patients with advanced ovarian cancer. Ongoing and future randomized trials will show whether or not this finding translates into improved survival.