Dose escalation combination carboplatin/cyclophosphamide chemotherapy for epithelial ovarian cancer

Dose intensification chemotherapy is currently under investigation in ovarian cancer. In order to establish an optimum dose for future colony stimulating factor trials, 16 patients with ovarian cancer were treated with dose-escalation combination carboplatin plus cyclophosphamide chemotherapy without growth factors. The initial carboplatin dose, 300 mg/m2, was increased to a maximum dose of 400 mg/m2. The initial cyclophosphamide dose, 600 mg/m2, was increased to a maximum dose of 1200 mg/m2. Of 10 patients completing 6 cycles, six patients (60%) were escalated to carboplatin 400 mg/m2 and cyclophosphamide 600-1200 mg/m2. Myelosuppression was severe, with all 6 patients requiring platelet and/or packed red blood cell transfusions. Based on these results, carboplatin 400 mg/m2 with cyclophosphamide 600 mg/m2 was selected as the starting dose with hematopoietic growth factors.