[Recent advances in ovarian cancer chemotherapy from the survival standpoint]

The following consensus has been reached over the last two decades from clinical research: 1) Single nonplatinum agents or nonplatinum combinations have failed to demonstrate a significantly longer median survival. 2) Platinum combinations are generally better than single-agent platinum when platinum is used at the same dose. 3) Cisplatin-based chemotherapy produced a substantial clinical improvement as indicated by increased response rate duration of response and time to progression, but the overall effect on survival has been modest. The higher doses of cisplatin, ranging from 12.5 to 50 mg/sm/week, have demonstrated a general trend for prolonged median survival. But a more escalated dose of platinum supported by PBSCT is an investigational setting to ensure the advantage for overall survival in the near future. This consensus has been achieved from analysis of clinical trials in Europe and the United States for ovarian cancer chemotherapy, but only a few Japanese clinical trials have showed a similar tendency in the manner of retrospective studies. Six cycles of chemotherapy of cisplatin/cyclophosphamide or carboplatin/cyclophosphamide have become the standard and yield clinical response rates of approximately 60-70% and 5-year survival of 15-25 percent for advanced ovarian cancer. Taxol is thought to be the next promising candidate for cisplatin combination and secondary chemotherapy for ovarian cancer. It augurs to improve the overall survival. We look forward to early use of taxol in Japan at the clinical level.