Single-agent cis-platinum therapy for advanced ovarian cancer

From May 1976 to July 1978, 100 patients with untreated stage III or IV ovarian carcinoma were entered into a prospective randomized clinical trial comparing melphalan, cis-platinum, hexamethylmelamine and cyclophosphamide, and a combination of hexamethylmelamine, cyclophosphamide, and doxorubicin hydrochloride (Adriamycin). The 22 patients who received cis-platinum, 18 of whom ultimately received hexamethylmelamine and cyclophosphamide therapy, are analyzed, and surgical and chemotherapeutic treatments are described. Response was evaluated by either clinical or surgical methods. Eleven of the 22 patients (50%) responded to cis-platinum treatment. Survival times ranged from 2 to 24 months, with a median survival time of 21.2 months. Gastrointestinal, hematologic, renal, and neurologic toxicities are reported; peripheral neuropathy constituted the major toxicity. Methods of alleviating or preventing neurotoxicity are discussed. It is concluded that cis-platinum as a single agent possesses definite activity against ovarian cancer.