Ovarian cancer - historical
The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. Is there a regimen missing from this list? See the main ovarian cancer page for current regimens.
24 regimens on this page
39 variants on this page
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Adjuvant chemotherapy for early stage disease
Cisplatin & Cyclophosphamide
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CP: Cyclophosphamide & Platinol (Cisplatin)
PC: Platinol (Cisplatin) & Cyclophosphamide
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Young et al. 2003 (GOG 95) | Phase III (C) | IP P32 | Seems not superior |
Preceding treatment
Chemotherapy
- Cisplatin (Platinol) 100 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 750 mg/m2 IV once on day 1
21-day cycle for 6 cycles
References
- GOG 95: Young RC, Brady MF, Nieberg RK, Long HJ, Mayer AR, Lentz SS, Hurteau J, Alberts DS. Adjuvant treatment for early ovarian cancer: a randomized phase III trial of intraperitoneal 32P or intravenous cyclophosphamide and cisplatin--a gynecologic oncology group study. J Clin Oncol. 2003 Dec 1;21(23):4350-5. link to original article contains protocol PubMed
First-line chemotherapy for advanced stage disease
Note: in a majority of these regimens, chemotherapy was preceded by primary debulking surgery.
CAP (Platinol)
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CAP: Cyclophosphamide, Adriamycin (Doxorubicin), Platinol (Cisplatin)
PAC: Platinol (Cisplatin), Adriamycin (Doxorubicin), Cyclophosphamide
Regimen
Study | Evidence | Comparator | Efficacy | Toxicity |
---|---|---|---|---|
Conte et al. 1986 | Phase III (E) | CP | Seems not superior | |
Bolis et al. 1987 | Phase III (E) | 1. Cisplatin 2. CP |
Seems to have superior PFS | |
Omura et al. 1989 | Phase III (E) | CP | Seems not superior | |
Parmar et al. 1998 (ICON2) | Phase III (C) | Carboplatin | Seems not superior | More toxic |
Parmar et al. 2002 (ICON3) | Phase III (C) | 1. Carboplatin 2. Carboplatin & Paclitaxel |
Seems not superior |
Chemotherapy
References
- Conte PF, Bruzzone M, Chiara S, Sertoli MR, Daga MG, Rubagotti A, Conio A, Ruvolo M, Rosso R, Santi L, Carnino F, Cottini M, Mossetti C, Guercio E, Gatti M, Siliquini PN, Prelato ML, Durando C, Giaccone G, Calciati A, Farinini D, Centonze M, Rugiati S, Parodi G, Messineo M, Storace A, Bernardini G, Misurale F, Alessandri S, Casini M, Ragni N, Foglia G, Bentivoglio G, Pescetto G. A randomized trial comparing cisplatin plus cyclophosphamide versus cisplatin, doxorubicin, and cyclophosphamide in advanced ovarian cancer. J Clin Oncol. 1986 Jun;4(6):965-71. Erratum in: J Clin Oncol 1986 Aug;4(8):1284. link to original article PubMed
- Bolis G, Marsoni S, Belloni C, Bianchi U, Bolis PF, Bortolozzi G, Colombo N, Epis A, Giardina G, Natale N, Pecorelli S, Redaelli U, Santoienna M, Valsecchi MG, Vassena L, Vergadoro F, Mangioni C; Gruppo Interegionale Cooperativo Oncologico Ginecologia. Randomised comparison of cisplatin with cyclophosphamide/cisplatin and with cyclophosphamide/doxorubicin/cisplatin in advanced ovarian cancer. Lancet. 1987 Aug 15;2(8555):353-9. link to original article PubMed
- Omura GA, Bundy BN, Berek JS, Curry S, Delgado G, Mortel R. Randomized trial of cyclophosphamide plus cisplatin with or without doxorubicin in ovarian carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol. 1989 Apr;7(4):457-65. link to original article PubMed
- Meta-analysis: The Ovarian Cancer Meta-Analysis Project. Cyclophosphamide plus cisplatin versus cyclophosphamide, doxorubicin, and cisplatin chemotherapy of ovarian carcinoma: a meta-analysis. J Clin Oncol. 1991 Sep;9(9):1668-74. link to original article PubMed
- ICON2: Parmar MKB, Torri V, Bonaventura A, Bonazzi C, Colombo N, Delaloye JF, Marsoni S, Mangioni C, Sandercock J, Sessa C, and Williams C; ICON Collaborators. ICON2: randomised trial of single-agent carboplatin against three-drug combination of CAP (cyclophosphamide, doxorubicin, and cisplatin) in women with ovarian cancer: International Collaborative Ovarian Neoplasm Study. Lancet. 1998 Nov 14;352(9140):1571-6. link to original article contains verified protocol PubMed
- ICON3: Parmar MKB, Adams M, Balestrino M, Bertelsen K, Bonazzi C, Calvert H, Colombo N, Delaloye JF, Durando A, Guthrie D, Hagen B, Harper P, Mangioni C, Perren T, Poole C, Qian W, Rustin G, Sandercock J, Tumolo S, Torri V, Vecchione F; International Collaborative Ovarian Neoplasm Group. Paclitaxel plus carboplatin versus standard chemotherapy with either single-agent carboplatin or cyclophosphamide, doxorubicin, and cisplatin in women with ovarian cancer: the ICON3 randomised trial. Lancet. 2002 Aug 17;360(9332):505-15. Erratum in: Lancet. 2003 Feb 22;361(9358):706. link to original article PubMed
CEP
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CEP: Cyclophosphamide, Epirubicin, Platinol (Cisplatin)
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Ray-Coquard et al. 2007 | Phase III (C) | Intensified CEP | Seems not superior |
Chemotherapy
References
- Ray-Coquard I, Paraiso D, Guastalla JP, Leduc B, Guichard F, Martin C, Chauvenet L, Haddad-Guichard Z, Lepillé D, Orfeuvre H, Gautier H, Castera D, Pujade-Lauraine E. Intensified dose of cyclophosphamide with G-CSF support versus standard dose combined with platinum in first-line treatment of advanced ovarian cancer a randomised study from the GINECO group. Br J Cancer. 2007 Nov 5;97(9):1200-5. Epub 2007 Oct 9. link to original article link to PMC article PubMed
Cisplatin monotherapy
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Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Fruscio et al. 2011 | Phase III (C) | Weekly cisplatin | Seems not superior |
Chemotherapy
- Cisplatin (Platinol) 75 mg/m2 IV once on day 1
21-day cycle for 6 cycles
References
- Fruscio R, Garbi A, Parma G, Lissoni AA, Garavaglia D, Bonazzi CM, Dell'anna T, Mangioni C, Milani R, Colombo N. Randomized phase III clinical trial evaluating weekly cisplatin for advanced epithelial ovarian cancer. J Natl Cancer Inst. 2011 Feb 16;103(4):347-51. Epub 2011 Jan 7. link to original article contains protocol PubMed
Cisplatin & Cyclophosphamide
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CP: Cyclophosphamide & Platinol (Cisplatin)
PC: Platinol (Cisplatin) & Cyclophosphamide
Variant #1, 50/600
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Conte et al. 1986 | Phase III (C) | PAC | Seems not superior |
Chemotherapy
- Cisplatin (Platinol) 50 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 600 mg/m2 IV once on day 1
28-day cycle for 6 cycles
Variant #2, 50/750
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Kaye et al. 1992 | Phase III (E) | Cisplatin & Cyclophosphamide 100/750 | Inferior OS |
McGuire et al. 1996 (GOG 111) | Phase III (E) | Cisplatin & Cyclophosphamide 100/750 | Inferior OS |
Preceding treatment
- GOG 111: Primary debulking surgery, with suboptimal debulking
Chemotherapy
- Cisplatin (Platinol) 50 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 750 mg/m2 IV once on day 1
21-day cycle for 6 cycles
Variant #3, 50/1000
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Omura et al. 1989 | Phase III (C) | CAP | Seems not superior |
Chemotherapy
- Cisplatin (Platinol) 50 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 1000 mg/m2 IV once on day 1
21-day cycle for 8 cycles
Variant #4, 75/600
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Swenerton et al. 1992 | Phase III (C) | Carboplatin & Cyclophosphamide | Seems not superior |
Chemotherapy
- Cisplatin (Platinol) 75 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 600 mg/m2 IV once on day 1
28-day cycle for 6 cycles
Variant #5, 75/750
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
van der Burg et al. 1995 | Phase III (C) | Cisplatin & Cyclophosphamide, with interval debulking | Inferior OS |
McGuire et al. 1996 (GOG 111) | Phase III (C) | Cisplatin & Paclitaxel | Inferior OS |
Piccart et al. 2000 (OV10) | Phase III (C) | Cisplatin & Paclitaxel | Inferior OS |
Preceding treatment
- GOG 111: Primary debulking surgery, with suboptimal debulking
- OV10: Primary debulking surgery, with optimal or suboptimal debulking
Chemotherapy
- Cisplatin (Platinol) 75 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 750 mg/m2 IV once on day 1
21-day cycle for 6 cycles
Variant #6, 100/600
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Alberts et al. 1992 | Phase III (C) | Carboplatin & Cyclophosphamide | Seems to have inferior OS |
Chemotherapy
- Cisplatin (Platinol) 100 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 600 mg/m2 IV once on day 1
21-day cycle for 6 cycles
Variant #7, 100/750
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Kaye et al. 1992 | Phase III (E) | Cisplatin & Cyclophosphamide 50/750 | Superior OS |
McGuire et al. 1996 (GOG 111) | Phase III (E) | Cisplatin & Cyclophosphamide 50/750 | Superior OS |
Chemotherapy
- Cisplatin (Platinol) 100 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 750 mg/m2 IV once on day 1
21-day cycle for 6 cycles
References
- Conte PF, Bruzzone M, Chiara S, Sertoli MR, Daga MG, Rubagotti A, Conio A, Ruvolo M, Rosso R, Santi L, Carnino F, Cottini M, Mossetti C, Guercio E, Gatti M, Siliquini PN, Prelato ML, Durando C, Giaccone G, Calciati A, Farinini D, Centonze M, Rugiati S, Parodi G, Messineo M, Storace A, Bernardini G, Misurale F, Alessandri S, Casini M, Ragni N, Foglia G, Bentivoglio G, Pescetto G. A randomized trial comparing cisplatin plus cyclophosphamide versus cisplatin, doxorubicin, and cyclophosphamide in advanced ovarian cancer. J Clin Oncol. 1986 Jun;4(6):965-71. Erratum in: J Clin Oncol 1986 Aug;4(8):1284. link to original article contains protocol PubMed
- Bolis G, Marsoni S, Belloni C, Bianchi U, Bolis PF, Bortolozzi G, Colombo N, Epis A, Giardina G, Natale N, Pecorelli S, Redaelli U, Santoienna M, Valsecchi MG, Vassena L, Vergadoro F, Mangioni C; Gruppo Interegionale Cooperativo Oncologico Ginecologia. Randomised comparison of cisplatin with cyclophosphamide/cisplatin and with cyclophosphamide/doxorubicin/cisplatin in advanced ovarian cancer. Lancet. 1987 Aug 15;2(8555):353-9. link to original article PubMed
- Omura GA, Bundy BN, Berek JS, Curry S, Delgado G, Mortel R. Randomized trial of cyclophosphamide plus cisplatin with or without doxorubicin in ovarian carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol. 1989 Apr;7(4):457-65. link to original article PubMed
- Alberts DS, Green S, Hannigan EV, O'Toole R, Stock-Novack D, Anderson P, Surwit EA, Malvlya VK, Nahhas WA, Jolles CJ. Improved therapeutic index of carboplatin plus cyclophosphamide versus cisplatin plus cyclophosphamide: final report by the Southwest Oncology Group of a phase III randomized trial in stages III and IV ovarian cancer. J Clin Oncol. 1992 May;10(5):706-17. Erratum in: J Clin Oncol 1992 Sep;10(9):1505. link to original article contains protocol PubMed
- Swenerton K, Jeffrey J, Stuart G, Roy M, Krepart G, Carmichael J, Drouin P, Stanimir R, O'Connell G, MacLean G, Kirk ME, Canetta R, Koski B, Shelley W, Zee B, Pater J. Cisplatin-cyclophosphamide versus carboplatin-cyclophosphamide in advanced ovarian cancer: a randomized phase III study of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol. 1992 May;10(5):718-26. link to original article contains verified protocol PubMed
- Kaye SB, Lewis CR, Paul J, Soukop M, Rankin M, Cassidy J, Davis JA, Reed S, MacLean A, Kennedy JH, Symonds RP, Duncan ID, Gordon HK, Kitchener HC, Cruickshank DJ, Swapp GA, Sarkar TK, Atkinson RJ, Crawford SM. Randomised study of two doses of cisplatin with cyclophosphamide in epithelial ovarian cancer. Lancet. 1992 Aug 8;340(8815):329-33. link to original article contains protocol PubMed
- van der Burg ME, van Lent M, Buyse M, Kobierska A, Colombo N, Favalli G, Lacave AJ, Nardi M, Renard J, Pecorelli S; Gynecological Cancer Cooperative Group of the European Organization for Research and Treatment of Cancer. The effect of debulking surgery after induction chemotherapy on the prognosis in advanced epithelial ovarian cancer. N Engl J Med. 1995 Mar 9;332(10):629-34. link to original article PubMed
- GOG 111: McGuire WP, Hoskins WJ, Brady MF, Kucera PR, Partridge EE, Look KY, Clarke-Pearson DL, Davidson M. Cyclophosphamide and cisplatin compared with paclitaxel and cisplatin in patients with stage III and stage IV ovarian cancer. N Engl J Med. 1996 Jan 4;334(1):1-6. link to original article contains verified protocol PubMed
- OV10: Piccart MJ, Bertelsen K, James K, Cassidy J, Mangioni C, Simonsen E, Stuart G, Kaye S, Vergote I, Blom R, Grimshaw R, Atkinson RJ, Swenerton KD, Trope C, Nardi M, Kaern J, Tumolo S, Timmers P, Roy JA, Lhoas F, Lindvall B, Bacon M, Birt A, Andersen JE, Zee B, Paul J, Baron B, Pecorelli S. Randomized intergroup trial of cisplatin-paclitaxel versus cisplatin-cyclophosphamide in women with advanced epithelial ovarian cancer: three-year results. J Natl Cancer Inst. 2000 May 3;92(9):699-708. link to original article contains verified protocol PubMed
Hexa-CAF
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Hexa-CAF: Hexalen (Altretamine), Cyclophosphamide, Adrucil (Fluorouracil), Folex (Methotrexate)
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Young et al. 1978 | Phase III (E) | Melphalan | Superior OS |
Neijt et al. 1984 | Phase III (C) | CHAP-5 | Inferior OS |
Chemotherapy
References
- Young RC, Chabner BA, Hubbard SP, Fisher RI, Bender RA, Anderson T, Simon RM, Canellos GP, DeVita VT Jr. Advanced ovarian adenocarcinoma: prospective clinical trial of melphalan (L-PAM) versus combination chemotherapy. N Engl J Med. 1978 Dec 7;299(23):1261-6. link to original article PubMed
- Neijt JP, ten Bokkel Huinink WW, van der Burg ME, van Oosterom AT, Vriesendorp R, Kooyman CD, van Lindert AC, Hamerlynck JV, van Lent M, van Houwelingen JC, Pindeo HM. Randomised trial comparing two combination chemotherapy regimens (Hexa-CAF vs CHAP-5) in advanced ovarian carcinoma. Lancet. 1984 Sep 15;2(8403):594-600. link to original article PubMed
Second-line therapy
Tamoxifen monotherapy
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Regimen
Study | Evidence | Comparator | Efficacy |
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Hurteau et al. 2010 (GOG 198) | Phase III (C) | Thalidomide | Seems not superior |
Note: to our knowledge, this regimen was not tested as an experimental arm in an RCT prior to becoming a standard comparator arm.
Hormonotherapy
Continued indefinitely
References
- GOG 198: Hurteau JA, Brady MF, Darcy KM, McGuire WP, Edmonds P, Pearl ML, Ivanov I, Tewari KS, Mannel RS, Zanotti K, Benbrook DM. Randomized phase III trial of tamoxifen versus thalidomide in women with biochemical-recurrent-only epithelial ovarian, fallopian tube or primary peritoneal carcinoma after a complete response to first-line platinum/taxane chemotherapy with an evaluation of serum vascular endothelial growth factor (VEGF): A Gynecologic Oncology Group Study. Gynecol Oncol. 2010 Dec;119(3):444-50. Epub 2010 Sep 17. link to original article PubMed
Intraperitoneal therapy
Cisplatin & Cyclophosphamide
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Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Alberts et al. 1996 (GOG 104) | Phase III (E) | Cisplatin (IV) & Cyclophosphamide | Seems to have superior OS |
Chemotherapy
References
- GOG 104: Alberts DS, Liu PY, Hannigan EV, O'Toole R, Williams SD, Young JA, Franklin EW, Clarke-Pearson DL, Malviya VK, DuBeshter B, Adelson MD, Hoskins WJ. Intraperitoneal cisplatin plus intravenous cyclophosphamide versus intravenous cisplatin plus intravenous cyclophosphamide for stage III ovarian cancer. N Engl J Med. 1996 Dec 26;335(26):1950-5. link to original article PubMed