Cisplatin-based chemotherapy of epithelial ovarian cancer

The current International Federation of Gynecology and Obstetrics (FIGO) staging system, independent prognostic factors, and review of the Gynecologic Oncology Group (GOG) studies in epithelial ovarian carcinoma are presented. With this background, approaches using cisplatin-based regimens in ovarian carcinoma trials are outlined. A short three-course cycle of cisplatin plus cyclophosphamide is currently being compared with intraperitoneal phosphorus 32 in high-risk stage I-II patients. In optimal stage III patients, cisplatin plus cyclophosphamide without doxorubicin in a recent GOG study was as effective as all three drugs. In suboptimal stage III patients, a current dose-intensity study is comparing 100 mg/m2 cisplatin plus 1 g/m2 cyclophosphamide for four courses to the previously studied eight courses of 50 mg/m2 cisplatin and 500 mg/m2 cyclophosphamide. Trials are also under way to determine the utility of intraperitoneal cisplatin in a phase III study of optimal stage III as first-line therapy and another study is active for second-line salvage.