Paclitaxel with carboplatin for the treatment of ovarian cancer

Paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) (135 mg/m2 over 24 hours) plus cisplatin (75 mg/m2 at a rate of I mg/min) every 3 weeks is widely accepted as the new standard of treatment for women with advanced epithelial ovarian cancer. A higher dose of paclitaxel over a shorter infusion period is under investigation as an alternative because it looks at least as effective and is more convenient to administer. However, in combination with cisplatin this dose-time schedule causes neurotoxicity in an important number of patients that can preclude the delivery of an adequate total dose. One way to decrease the incidence of this side effect is to substitute cisplatin with the analogue carboplatin. From the present data the conclusion is warranted that it is feasible to combine both drugs in an adequate dose and with acceptable toxicity. The combination would allow administration to outpatients and may be more tolerable, allowing prolonged treatment. The combination also looks attractive for re-treatment of women who relapse after completing their first-line paclitaxel/cisplatin-based therapy and who have chemotherapy-sensitive disease and prognostic features indicating that there is a high likelihood of achieving a second durable remission.