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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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only.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.

15 regimens on this page
22 variants on this page


Contents

Adjuvant chemotherapy for early stage disease

Cisplatin & Cyclophosphamide

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CP: Cyclophosphamide & Platinol (Cisplatin)
PC: Platinol (Cisplatin) & Cyclophosphamide

Regimen

Study Evidence Comparator Comparative Efficacy
Young et al. 2003 (GOG 95) Phase III (C) IP P32 Did not meet primary endpoint of OS

Preceding treatment

Chemotherapy

21-day cycle for 6 cycles

References

  1. 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

Melphalan monotherapy

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Regimen

Study Evidence Comparator Comparative Efficacy
Klaassen et al. 1988 Phase III (E-switch-ooc) WAI Seems to have superior DFS

Chemotherapy

References

  1. Klaassen D, Shelley W, Starreveld A, Kirk M, Boyes D, Gerulath A, Levitt M, Fraser R, Carmichael J, Methot Y, Willan A; National Cancer Institute of Canada Clinical Trials Group. Early stage ovarian cancer: a randomized clinical trial comparing whole abdominal radiotherapy, melphalan, and intraperitoneal chromic phosphate: a National Cancer Institute of Canada Clinical Trials Group report. J Clin Oncol. 1988 Aug;6(8):1254-63. link to original article 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)
DCP: Doxorubicin, Cyclophosphamide, Platinol (Cisplatin)
PAC: Platinol (Cisplatin), Adriamycin (Doxorubicin), Cyclophosphamide

Regimen

Study Years of enrollment Evidence Comparator Comparative Efficacy Comparative Toxicity
Omura et al. 1986 (GOG 47) Phase III (E-esc) AC Superior CR rate
Conte et al. 1986 Phase III (E-esc) CP Seems to have superior surgical CR rate
Bolis et al. 1987 Phase III (E-esc) 1. Cisplatin
2. CP
Seems to have superior PFS
Alberts et al. 1989 (SWOG S7925) Phase III (C) 1. DC & BCG Superior OS
2. DCP & BCG Did not meet endpoint of OS
Omura et al. 1989 (GOG 52) Phase III (E-esc) CP Did not meet primary endpoint of PFS24
Creasman et al. 1990 (GOG 60) 1982-1986 Phase III (C) CAP & BCG Did not meet endpoints of PFS/OS
Parmar et al. 1998 (ICON2) Phase III (C) Carboplatin Did not meet primary endpoint of OS More toxic
Parmar et al. 2002 (ICON3) Phase III (C) 1. Carboplatin
2. Carboplatin & Paclitaxel
Did not meet primary endpoint of OS

Chemotherapy

References

  1. GOG 47: Omura G, Blessing JA, Ehrlich CE, Miller A, Yordan E, Creasman WT, Homesley HD. A randomized trial of cyclophosphamide and doxorubicin with or without cisplatin in advanced ovarian carcinoma: a Gynecologic Oncology Group study. Cancer. 1986 May 1;57(9):1725-30. link to original article PubMed
  2. 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
  3. 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
  4. SWOG S7925: Alberts DS, Mason-Liddil N, O'Toole RV, Abbott TM, Kronmal R, Hilgers RD, Surwit EA, Eyre HJ, Baker LH. Randomized phase III trial of chemoimmunotherapy in patients with previously untreated stages III and IV suboptimal disease ovarian cancer: a Southwest Oncology Group Study. Gynecol Oncol. 1989 Jan;32(1):8-15. link to original article PubMed
  5. GOG 52: 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
  6. GOG 60: Creasman WT, Omura GA, Brady MF, Yordan E, DiSaia PJ, Beecham J. A randomized trial of cyclophosphamide, doxorubicin, and cisplatin with or without bacillus Calmette-Guerin in patients with suboptimal stage III and IV ovarian cancer: a Gynecologic Oncology Group study. Gynecol Oncol. 1990 Dec;39(3):239-43. link to original article PubMed
  7. 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
  8. ICON2: Parmar MKB, Torri V, Bonaventura A, Bonazzi C, Colombo N, Delaloye JF, Marsoni S, Mangioni C, Sandercock J, Sessa C, Williams C; ICON. 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
  9. 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

Carboplatin & Cyclophosphamide

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Regimen

Study Years of enrollment Evidence Comparator Comparative Efficacy
Alberts et al. 1992 (SWOG 8412) 1985-1989 Phase III (E-RT-switch-ic) Cisplatin & Cyclophosphamide Seems to have superior OS
Swenerton et al. 1992 1985-1989 Phase III (E-RT-switch-ic) Cisplatin & Cyclophosphamide Did not meet primary endpoint of PFS

Chemotherapy

References

  1. SWOG 8412: 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
  2. 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; National Cancer Institute of Canada Clinical Trials Group. 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

CEP

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CEP: Cyclophosphamide, Epirubicin, Platinol (Cisplatin)

Regimen

Study Evidence Comparator Comparative Efficacy
Wils et al. 1999 Phase III (C) EP Did not meet endpoints of pCR rate/OS
Ray-Coquard et al. 2007 Phase III (C) CEP; intensified Did not meet primary endpoint of OS24

Note: to our knowledge, this regimen was not tested as an experimental arm in an RCT prior to becoming a standard comparator arm.

Chemotherapy

References

  1. Wils J, van Geuns H, Stoot J, Bergmans M, Boschma F, Bron H, Degen J, Erdkamp F, van Erp J, Haest J, Iding R, Lalisang F, de Pree N, de Rooy C, Snijders M, Schepers J, Vreeswijk J, Wals J, Werter M, Wetzels L, Smeets J, Schouten L. Cyclophosphamide, epirubicin and cisplatin (CEP) versus epirubicin plus cisplatin (EP) in stage Ic-IV ovarian cancer: a randomized phase III trial of the Gynecologic Oncology Group of the Comprehensive Cancer Center Limburg. Anticancer Drugs. 1999 Mar;10(3):257-61. PubMed
  2. 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; GINECO. 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

CHAD

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CHAD: Cyclophosphamide, Hexalen (Altretamine), Adriamycin (Doxorubicin), DDP (Cisplatin)

Regimen

Study Evidence Comparator Comparative Efficacy
Wadler et al. 1996 (ECOG E2878) Phase III (E-esc) Melphalan Seems to have superior TTTF

Chemotherapy

References

  1. ECOG E2878: Wadler S, Yeap B, Vogl S, Carbone P. Randomized trial of initial therapy with melphalan versus cisplatin-based combination chemotherapy in patients with advanced ovarian carcinoma: initial and long term results--Eastern Cooperative Oncology Group Study E2878. Cancer. 1996 Feb 15;77(4):733-42. link to original article PubMed

Chlorambucil & Cisplatin

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Regimen

Study Evidence Comparator Comparative Efficacy
Barker & Wiltshaw 1981 Phase III (C) Chlorambucil, Cisplatin, Doxorubicin Did not meet endpoint of ORR

Chemotherapy

References

  1. Barker GH, Wiltshaw E. Randomised trial comparing low-dose cisplatin and chlorambucil with low-dose cisplatin, chlorambucil, and doxorubicin in advanced ovarian carcinoma. Lancet. 1981 Apr 4;1(8223):747-50. link to original article PubMed

Cisplatin monotherapy

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Regimen

Study Evidence Comparator Comparative Efficacy
Fruscio et al. 2011 Phase III (C) Cisplatin; weekly Did not meet primary endpoint of PFS

Chemotherapy

21-day cycle for 6 cycles

References

  1. Mangioni C, Bolis G, Pecorelli S, Bragman K, Epis A, Favalli G, Gambino A, Landoni F, Presti M, Torri W, Vassena L, Zanaboni F, Marsoni S. Randomized trial in advanced ovarian cancer comparing cisplatin and carboplatin. J Natl Cancer Inst. 1989 Oct 4;81(19):1464-71. link to original article PubMed
  2. Taylor AE, Wiltshaw E, Gore ME, Fryatt I, Fisher C. Long-term follow-up of the first randomized study of cisplatin versus carboplatin for advanced epithelial ovarian cancer. J Clin Oncol. 1994 Oct;12(10):2066-70. link to original article contains protocol PubMed
  3. 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)
CPC: CisPlatin & Cyclophosphamide
PC: Platinol (Cisplatin) & Cyclophosphamide

Regimen variant #1, 50/600

Study Evidence Comparator Comparative Efficacy
Conte et al. 1986 Phase III (C) PAC Seems to have inferior surgical CR rate

Chemotherapy

28-day cycle for 6 cycles

Regimen variant #2, 50/750

Study Evidence Comparator Comparative Efficacy
Kaye et al. 1992 Phase III (E-de-esc) Cisplatin & Cyclophosphamide; 100/750 Inferior OS
McGuire et al. 1996 (GOG 111) Phase III (E-de-esc) Cisplatin & Cyclophosphamide; 100/750 Inferior OS

Preceding treatment

Chemotherapy

21-day cycle for 6 cycles

Regimen variant #3, 50/1000

Study Evidence Comparator Comparative Efficacy
Omura et al. 1989 (GOG 52) Phase III (C) CAP Did not meet primary endpoint of PFS24

Chemotherapy

21-day cycle for 8 cycles

Regimen variant #4, 75/600

Study Evidence Comparator Comparative Efficacy
Swenerton et al. 1992 Phase III (C) Carboplatin & Cyclophosphamide Did not meet primary endpoint of PFS

Chemotherapy

28-day cycle for 6 cycles

Regimen variant #5, 75/750

Study Evidence Comparator Comparative 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
Breitbach et al. 2002 Phase III (C) Cisplatin & Treosulfan Did not meet primary endpoint of TTP

Note: the dosing for Breitbach et al. 2002 could not be confirmed from the abstract.

Preceding treatment

Chemotherapy

21-day cycle for 6 cycles

Regimen variant #6, 100/600

Study Evidence Comparator Comparative Efficacy
Alberts et al. 1992 (SWOG 8412) Phase III (C) Carboplatin & Cyclophosphamide Seems to have inferior OS
Windbichler et al. 2000 Phase III (C) Cisplatin, Cyclophosphamide, IFN gamma Seems to have inferior PFS
Dittrich et al. 2003 Phase III (C) Carboplatin & Cisplatin Did not meet primary endpoints of PFS/OS

Chemotherapy

21-day cycle for 6 cycles

Regimen variant #7, 100/750

Study Evidence Comparator Comparative Efficacy
Kaye et al. 1992 Phase III (E-esc) Cisplatin & Cyclophosphamide; 50/750 Superior OS
McGuire et al. 1996 (GOG 111) Phase III (E-esc) Cisplatin & Cyclophosphamide; 50/750 Superior OS

Chemotherapy

21-day cycle for 6 cycles

Regimen variant #8, 100/1000

Study Evidence Comparator Comparative Efficacy
Misset et al. 2001 Phase II/III (C) Cyclophosphamide & Oxaliplatin Did not meet endpoints of PFS/OS

Chemotherapy

21-day cycle for 6 cycles

References

  1. 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
  2. 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
  3. GOG 52: 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
  4. SWOG 8412: 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
  5. 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; National Cancer Institute of Canada Clinical Trials Group. 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
  6. Kaye SB, Lewis CR, Paul J, Duncan ID, Gordon HK, Kitchener HC, Cruickshank DJ, Atkinson RJ, Soukop M, Rankin EM, Cassidy J, Davis JA, Reed NS, Crawford SM, MacLean A, Swapp GA, Sarkar TK, Kennedy JH, Symonds RP. 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
  7. 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 Organisation 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
  8. 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
  9. Windbichler GH, Hausmaninger H, Stummvoll W, Graf AH, Kainz C, Lahodny J, Denison U, Müller-Holzner E, Marth C. Interferon-gamma in the first-line therapy of ovarian cancer: a randomized phase III trial. Br J Cancer. 2000 Mar;82(6):1138-44. link to original article link to PMC article contains protocol PubMed
  10. 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
  11. Misset JL, Vennin P, Chollet PH, Pouillart P, Laplaige PH, Frobert JL, Castera D, Fabro M, Langlois D, Cortesi E, Lucas V, Gamelin E, Laadem A, Otero J. Multicenter phase II-III study of oxaliplatin plus cyclophosphamide vs cisplatin plus cyclophosphamide in chemonaive advanced ovarian cancer patients. Ann Oncol. 2001 Oct;12(10):1411-5. link to original article contains protocol PubMed
  12. Breitbach GP, Meden H, Schmid H, Kühn W, Sass G, Schach S, Schmidt-Rohde P, Bastert G; GTOC Study Group. Treosulfan in the treatment of advanced ovarian cancer: a randomised co-operative multicentre phase III-study. Anticancer Res. 2002 Sep-Oct;22(5):2923-32. PubMed
  13. Dittrich Ch, Sevelda P, Salzer H, Obermair A, Speiser P, Breitenecker G, Schemper M, Kaider A; Austrian Ovarian Cancer Study Group. Lack of impact of platinum dose intensity on the outcome of ovarian cancer patients: 10-year results of a prospective randomised phase III study comparing carboplatin-cisplatin with cyclophosphamide-cisplatin. Eur J Cancer. 2003 May;39(8):1129-40. Erratum in: Eur J Cancer. 2004 Mar;40(4):627. link to original article contains protocol PubMed

Cisplatin, Cyclophosphamide, Interferon gamma-1b

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Regimen

Study Evidence Comparator Comparative Efficacy
Windbichler et al. 2000 Phase III (E-esc) Cisplatin & Cyclophosphamide Seems to have superior PFS

Chemotherapy

Immunotherapy

References

  1. Windbichler GH, Hausmaninger H, Stummvoll W, Graf AH, Kainz C, Lahodny J, Denison U, Müller-Holzner E, Marth C. Interferon-gamma in the first-line therapy of ovarian cancer: a randomized phase III trial. Br J Cancer. 2000 Mar;82(6):1138-44. link to original article link to PMC article PubMed

Hexa-CAF

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Hexa-CAF: Hexalen (Altretamine), Cyclophosphamide, Adrucil (Fluorouracil), Folex (Methotrexate)

Regimen

Study Evidence Comparator Comparative Efficacy
Young et al. 1978 Phase III (E-esc) Melphalan Superior OS
Neijt et al. 1984 Phase III (C) CHAP-5 Inferior OS

Chemotherapy

References

  1. 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
  2. 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, Pinedo 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

Melphalan monotherapy

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Regimen

Study Evidence Comparator Comparative Efficacy
Young et al. 1978 Phase III (C) Hexa-CAF Inferior OS
Park et al. 1980 (GOG 3) Phase III (C) 1. 5-FU & Melphalan
2. 5-FU, Dactinomycin, Melphalan
3. 5-FU, Cyclophosphamide, Dactinomycin
Did not meet endpoint of PFS/OS
Miller et al. 1980 Phase III (C) 5-FU, Melphalan, MTX Did not meet endpoints of ORR/OS
Omura et al. 1983 (GOG 22) Phase III (C) 1. Altretamine & Melphalan
2. AC
Seems to have inferior CR rate
Wadler et al. 1996 (ECOG E2878) Phase III (C) CHAD Seems to have inferior TTTF

Chemotherapy

References

  1. 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
  2. GOG 3: Park RC, Blom J, Disaia PJ, Lagasse LD, Blessing JA. Treatment of women with disseminated or recurrent advanced ovarian cancer with melphalan alone in combination with 5-fluorouracil and dactinomycin or with the combination of cytoxan, 5-fluorouracil and dactinomycin. Cancer. 1980 May 15;45(10):2529-42. link to original article PubMed
  3. Miller AB, Klaassen DJ, Boyes DA, Dodds DJ, Gerulath A, Kirk ME, Levitt M, Pearson JG, Wall C. Combination v sequential therapy with melphalan, 5-fluorouracil and methotrexate for advanced ovarian cancer. Can Med Assoc J. 1980 Sep 6;123(5):365-71. link to original article PubMed
  4. GOG 22: Omura GA, Morrow CP, Blessing JA, Miller A, Buchsbaum HJ, Homesley HD, Leone L. A randomized comparison of melphalan versus melphalan plus hexamethylmelamine versus adriamycin plus cyclophosphamide in ovarian carcinoma. Cancer. 1983 Mar 1;51(5):783-9. link to original article PubMed
  5. ECOG E2878: Wadler S, Yeap B, Vogl S, Carbone P. Randomized trial of initial therapy with melphalan versus cisplatin-based combination chemotherapy in patients with advanced ovarian carcinoma: initial and long term results--Eastern Cooperative Oncology Group Study E2878. Cancer. 1996 Feb 15;77(4):733-42. link to original article PubMed

Second-line therapy

Altretamine & Cisplatin

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Regimen

Study Evidence
Vogl et al. 1979 Non-randomized

Chemotherapy

References

  1. Vogl SE, Greenwald E, Kaplan BH, Moukhtar M, Wollner D. Ovarian cancer: effective treatment after alkylating-agent failure. JAMA. 1979 May 4;241(18):1908-11. link to original article PubMed

CAP (Platinol)

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CAP: Cyclophosphamide, Adriamycin (Doxorubicin), Platinol (Cisplatin)

Regimen

Study Evidence Comparator Comparative Efficacy
Cantù et al. 1999 Phase III (C) Paclitaxel Seems to have superior OS

Chemotherapy

References

  1. Cantù MG, Buda A, Parma G, Rossi R, Floriani I, Bonazzi C, Dell'Anna T, Torri V, Colombo N. Randomized controlled trial of single-agent paclitaxel versus cyclophosphamide, doxorubicin, and cisplatin in patients with recurrent ovarian cancer who responded to first-line platinum-based regimens. J Clin Oncol. 2002 Mar 1;20(5):1232-7. link to original article PubMed

Tamoxifen monotherapy

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Regimen

Study Years of enrollment Evidence Comparator Comparative Efficacy
Hurteau et al. 2010 (GOG 198) 2003-2007 Phase III (C) Thalidomide Did not meet primary endpoint of PFS

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

  1. 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 Comparative Efficacy
Alberts et al. 1996 (GOG 104) Phase III (E-switch-ic) Cisplatin (IV) & Cyclophosphamide Seems to have superior OS

Chemotherapy

References

  1. 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