New developments with carboplatin in the treatment of ovarian cancer

On the basis of prospective randomized comparisons, carboplatin now can be considered to have replaced cisplatin as the induction chemotherapy of choice for patients with advanced ovarian cancer. While its equal efficacy and lesser toxicity are encouraging features of carboplatin therapy, the primary goal of chemotherapy for ovarian cancer remains to improve cure rates. It is in this regard that new experimental studies with carboplatin have the potential for improving survival. In particular, studies of dose intensity of platinum compounds are now possible with high-dose carboplatin together with autologous bone marrow transplantation and cytokines. The dose-limiting toxicity of carboplatin is myelosuppression, particularly thrombocytopenia. It is hoped that the new cytokine, interleukin-3, will be useful in reversing this particular toxicity and permitting further dose escalation. Additional studies are in progress to evaluate the benefits of combining carboplatin and cisplatin in an effort to maximize dose intensity and avoid overlapping toxicities.