According to an article recently published in the Journal of Clinical Oncology, the addition of the chemotherapy agent Ellence® (epirubicin) to the standard chemotherapy regimen of Paraplatin® (carboplatin) and Taxol® (paclitaxel) does not improve outcomes compared with carboplatin/paclitaxel only in advanced ovarian cancer.
Ovarian cancer is the fourth leading cause of cancer death among women in the U.S.; according to the American Cancer Society, an estimated 22,220 new cases were diagnosed in 2005.
Over the past 10 years, platinum-based chemotherapy regimens (regimens containing carboplatin or cisplatin) have become the mainstay of treatment for women with advanced ovarian cancer. Most commonly, the chemotherapy regimen containing a platinum plus paclitaxel is used for the treatment of advanced ovarian cancer.
Advanced ovarian cancer refers to cancer that has spread from the ovary to several or distant sites in the body. Unfortunately, long-term survival remains poor for patients with this disease. Researchers therefore continue to evaluate new regimens and combinations of chemotherapy agents in the treatment of ovarian cancer.
Researchers from Europe recently conducted a clinical trial to evaluate the addition of Ellence to carboplatin/paclitaxel in the treatment of advanced ovarian cancer. Ellence kills cancer cells through a different biologic mechanism than either carboplatin or paclitaxel, so researchers were hopeful that its addition would augment anticancer effects.
This trial included 1,282 patients who were treated with either Ellence/carboplatin/paclitaxel or carboplatin/paclitaxel between 1997 and 2000. Overall, the addition of Ellence did not improve outcomes:
- Median overall survival was 45.8 months for patients treated with Ellence/carboplatin/paclitaxel and 41 months for those treated carboplatin/paclitaxel.
- Median progression-free survival was approximately 18 months for both groups of patients.
- Serious side effects were more common among patients treated with Ellence/carboplatin/paclitaxel.
- Quality of life was reduced among patients treated with the addition of Ellence compared to those treated with carboplatin/paclitaxel alone.
The researcher concluded that the addition of Ellence to carboplatin/paclitaxel does not significantly improve outcomes compared to carboplatin/paclitaxel alone in the treatment of advanced ovarian cancer. Furthermore, the addition of Ellence increased side effects and reduced quality of life for these patients.
Reference: du Bois A, Weber B, Rochon J, et al. Addition of Epirubicin As a Third Drug to Carboplatin-Paclitaxel in First-Line Treatment of Advanced Ovarian Cancer: A Prospectively Randomized Gynecologic Cancer Intergroup Trial by the Arbeitsgemeinschaft Gynaekologische Onkologie Ovarian Cancer Study Group and the Groupe d’Investigateurs Nationaux pour l’Etude des Cancers Ovariens. Journal of Clinical Oncology. 2006; 24: 1127-1135.