Improved chemotherapy for ovarian cancer with cis-diamminedichloroplatinum and adriamycin

In a prospective controlled randomized trial, patients with advanced ovarian carcinoma (FIGO Stage III or IV) were treated with cis-diamminedichloroplatinum (II), (DDP), alone, DDP and Adriamycin (ADM), or Triethylenethiophosphoramide (ThioTEPA) and methotrexate (MTX). DDP alone produces objective responses in 31% of evaluable patients, ThioTEPA and MTX in 36%. The combination of DDP and ADM produces the best response rate, 80% (.01 less than P less than 0.25). The risk of progression or death is substantially reduced for the two DDP regimens combined when compared with ThioTEPA-MTX (P = .03). Multivariate analysis further suggests the superiority of the two DDP regimens because poorly differentiated tumors and large, greater than 2 cm, residual tumors failed to produce their usual adverse effect on prognosis when patients were treated with the two DDP regimens. Patients with poorly differentiated tumors or tumors of unknown grade treated with platinum or DDP-ADM experienced better survival than similar patients treated with ThioTEPA (P = .01).