Cis-platinum plus high-dose methotrexate. Toxicity and efficacy in ovarian carcinoma

Cis-platinum plus high-dose methotrexate with citrovorum factor rescue underwent an initial evaluation of toxicity in patients with pelvic or abdominal adenocarcinoma and a subsequent efficacy trial in proven ovarian cancers. Forty-five patients with advanced abdominal adenocarcinoma were evaluable for toxicity. Toxicity was minimal and was not exacerbated by the presence of effusions or by modestly compromised renal function. Twenty-six patients had definite ovarian primaries and were evaluable for efficacy. All but four were refractory to standard therapy. Seven achieved either complete response (four) or partial response (three). Four additional patients showed lesser, but clinically important, objective responses. Patients who had not received prior therapy all responded with three of the four attaining complete response lasting from 7-22+ months. This regimen is well tolerated and has definite tumoricidal activity even in heavily pretreated patients.