ABSTRACT
In spite of a large number of active drugs against this disease (Table 1) (1-29), current drug treatments for ovarian cancer are based mostly on two premises: (a) that the platinum up to an optimal dose intensity represents the ‘‘core’’ of any treatment regimen; and (b) that cisplatin and carboplatin yield similar results. Recent therapeutic concepts applicable to all patients presenting in stages III and IV have stressed that the initial treatment should consist of six cycles of taxane plus platinum-based combination (1,2,9). Paclitaxel plus carboplatin have been widely adopted worldwide as the standard chemotherapy treatment following surgical debulking (11,12). These recommendations are based on two clinical trials that have established the superiority of paclitaxel+cisplatin (13) over the prior standard of the Gynecologic Oncology Group (GOG) and the European Organization for Research and Treatment of Cancer (EORTC), which consisted of cisplatin plus cyclophosphamide (5,6), and several clinical trials establishing equivalence of carboplatin with cisplatin in this combination. Efforts have been ongoing to improve on these results primarily by devising triplets or by sequential doublets, and a large trial comparing new regimens has been launched by the GOG with international collaborators. To date, large trials of newer regimens by the German Arbeitgemenschaft Gynaekologische Onkologie (AGO) and others have not shown clear superiority over the current standard, but await full publication.
