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Chemotherapy for recurrent epithelial ovarian cancer previously treated with platinum -a systematic review of the evidence from randomized trials

  • M. Fung Kee Fung1,*,
  • M. E. Johnston2
  • E. A. Eisenhauer3
  • L. Elit4
  • H. W Hirte5
  • B. Rosen6

1On behalf of the Cancer Care Ontario Practice Guidelines Initiative Gynecology Disease Site Group, Department of Obstetrics and Gynaecology, University of Ottawa, Ottowa, ON Head, Division of Surgical Oncology, Ottawa Regional Cancer Centre, Ottawa ON Chair, Gynecology Disease Site Group, Cancer Care Ontario Practice Guidelines Initiative, Canada

2Research Assistant, Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton ON, Canada

3Director, Investigational New Drug Program, National Cancer Institute of Canada Clinical Trials Group, Professor, Department of Oncology, Queens University, Kingston ON, Canada

4Gynecologic Oncologist, Division of Gynecologic Oncology, Hamilton Regional Cancer Centre, Assistant Professor, Department of Obstetrics & Gynecology, McMaster University, Hamilton ON, Canada

5Head of Medical Oncology, Hamilton Regional Cancer Centre, Associate Professor, Departments of Medicine and Obstetrics & Gynecology, McMaster University, Hamilton ON, Canada

6Associate Professor , Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Toronto, Toronto ON, Canada

DOI: 10.12892/ejgo200201104 Vol.23,Issue 2,March 2002 pp.104-110

Published: 10 March 2002

*Corresponding Author(s): M. Fung Kee Fung E-mail:

Abstract

Purpose: To evaluate the chemotherapeutic options for women with recurrent epithelial ovarian cancer who have received platinum-based chemotherapy.

Methods: A systematic search of the Medline, CancerLit and Cochrane Library databases was performed for the period from 1984 to June 2001 to find randomized trials comparing second- or higher-line chemotherapy regimens in patients with recurrent platinum-pretreated epithelial ovarian cancer.

Results: Seven randomized trials have failed to demonstrate the clear superiority of any one chemotherapy regimen in terms of improvements in long-term survival, quality of life or response rate. One trial detected a statistically significant difference between treatments in progression-free survival, which was longer with cyclophosphamide/doxorubicin/cisplatin than with paclitaxel in women with platinum-sensitive ovarian cancer. Another trial did not show a difference between liposomal doxorubicin and topotecan overall in women with recurrent ovarian cancer but a subgroup analysis detected a significant survival advantage for liposomal doxorubicin over topotecan in women with platinum-sensitive disease.

Conclusion: The evidence available does not support firm conclusions about the preferred chemotherapy regimen for recurrent ovarian cancer. Randomized trials that compare new drugs with current standard treatments are needed.

Keywords

Ovarian cancer, Recurrent, Chemotherapy, Platinum

Cite and Share

M. Fung Kee Fung,M. E. Johnston,E. A. Eisenhauer,L. Elit,H. W Hirte,B. Rosen. Chemotherapy for recurrent epithelial ovarian cancer previously treated with platinum -a systematic review of the evidence from randomized trials. European Journal of Gynaecological Oncology. 2002. 23(2);104-110.

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