Combination of CPT-11 with cisplatin as first-line chemotherapy in advanced epithelial ovarian cancer

As CPT-11 was shown to be efficacious in recurrent ovarian cancer, a phase II trial has been undertaken at a recommended dose determined in the phase I trials of combination therapy of CPT-11 with cisplatin (CDDP). As first-line chemotherapy, 60 mg/m(2) of CPT-11 (on days 1, 8, and 15) and 60 mg/m(2) of CDDP (on day 1) were intravenously administered to patients with epithelial ovarian cancer with residual lesions larger than 2 cm, and patients who underwent exploratory laparotomy. Case 1 and 2 achieved CR and PR after completion of the first and second courses, respectively. After the third course when CA125 values turned negative, secondary cytoreductive surgery was performed in both cases, and the tumor was completely extirpated. Dose limiting toxicity was neutropenia, which was managed by administration of granulocyte stimulating factor or by skipping the administration of CPT-11. In Case 2, the number of platelets decreased with repetition of the courses. Grade 3 or worse diarrhea was not observed. The combination therapy of CPT-11 with CDDP is considered to be safe and efficacious in treatment of epithelial ovarian cancer.