According to the results of a Phase III clinical trial published in the Journal of Clinical Oncology, the chemotherapy drugs Gemzar® (gemcitabine) and Doxil® (pegylated liposomal doxorubicin) are similarly effective against ovarian cancer that is resistant to platinum-based chemotherapy.
Ovarian cancer is the leading cause of gynecologic cancer-related death in the United States. Initial treatment often includes a platinum-based chemotherapy regimen.
Women who experience cancer progression within six months of treatment with a platinum-based chemotherapy regimen are considered to have platinum-resistant cancer. Doxil is one of the chemotherapy drugs that may be used in the treatment of platinum-resistant ovarian cancer, but other treatment approaches continue to be evaluated.
To compare Doxil to Gemzar for the treatment of platinum-resistant ovarian cancer, researchers conducted a Phase III clinical trial among 195 women. All women had experienced cancer progression within six months of prior platinum-based therapy.
Half the women were treated with Gemzar and half were treated with Doxil. Women who experienced cancer progression or unacceptable adverse effects of treatment were allowed to switch to the other drug.
- Survival without cancer progression was 3.6 months in women treated with Gemzar and 3.1 months in women treated with Doxil.
- Overall survival was 12.7 months in women treated with Gemzar and 13.5 months in the women treated with Doxil.
- 6.1% of women treated with Gemzar experienced a complete or partial disappearance of detectable cancer compared with 8.3% of women treated with Doxil.
- Side effects that were more common with Gemzar included constipation, nausea and vomiting, fatigue, and low white blood cell levels (neutropenia). Side effects that were more common with Doxil included hand-foot syndrome and mouth sores (mucositis).
These results suggest that Gemzar and Doxil are similarly effective against platinum-resistant ovarian cancer, and that Gemzar may be an acceptable alternative to Doxil in this setting.
Reference: Mutch DG, Orlando M, Goss T et al. Randomized phase III trial of gemcitabine compared with pegylated liposomal doxorubicin in patients with platinum-resistant ovarian cancer. Journal of Clinical Oncology. 2007;25:2811-2818.