First line combination chemotherapy with cisplatin and etoposide in advanced ovarian cancer

Thirty-one consecutive patients with advanced epithelial ovarian cancer entered a phase II study with cisplatin and etoposide combination chemotherapy. None of them had received prior chemotherapy or radiotherapy. Most patients had advanced (88%) or far advanced (61%) disease. All 31 patients are evaluable for toxicity which was significant and led to removal of five (16%) patients from the study. Of the 23 patients evaluable for response there were four clinical complete (CR) and eight partial (PR) responders for a total clinical response rate of 52% of evaluable patients and 39% of all patients. Eight patients (four clinical CR and four good PR) have undergone second look laparotomy with pathological CR in one of the clinical CR patients. Median survival time for responders and non-responders is 19 and 8 months respectively. The results obtained appear to be inferior to other cisplatin based combinations. Although this could be attributed to the unusually high proportion of patients with bulky disease and stage IV patients, we feel that the study suggests that etoposide did not add any benefits for this patient population to cisplatin as a single agent.