Skip to main content
Log in

Dose-dense paclitaxel and carboplatin vs. conventional paclitaxel and carboplatin as neoadjuvant chemotherapy for advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer: a retrospective study

  • Original Article
  • Published:
International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Background

The purpose of this study was to determine the optimal regimen of neoadjuvant chemotherapy (NAC) for advanced epithelial ovarian, fallopian tube, and peritoneal cancers.

Methods

A clinical information survey involving 171 patients with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer was conducted. These patients underwent NAC followed by interval debulking surgery at the Hyogo Cancer Center (Hyogo, Japan) between January 2006 and December 2015.

Results

The median observation period was 41 (range 4–138) months. Dose-dense paclitaxel and carboplatin (TC) was administered in 101 patients (59%); tri-weekly TC was administered 70 patients (41%). Median progression-free survival was 21 [95% confidence interval (CI) 18–23] months and 15 (95% CI 13–17) months in the dose-dense TC and conventional-TC group [hazard ratio (HR) = 0.69, 95% CI 0.46–0.96; p = 0.02], respectively. The median overall survival was 59 (95% CI 46–72) and 40 (95% CI 32–57) months in the dose-dense TC group and conventional-TC group (HR = 0.72, 95% CI 0.48–1.06; p = 0.09). Multivariate analysis for progression-free survival demonstrated that dose-dense TC represented an independent prognostic factor (HR = 0.70, 95% CI 0.50–0.99; p = 0.04).

Conclusions

Dose-dense TC is a promising regimen of NAC for advanced epithelial ovarian cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Karam A, Ledermann JA, Kim JW et al (2017) Fifth Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup: first-line interventions. Ann Oncol 28:711–717

    Article  CAS  Google Scholar 

  2. Muggia F (2009) Platinum compounds 30 years after the introduction of cisplatin: implications for the treatment of ovarian cancer. Gynecol Oncol 112:275–281

    Article  CAS  Google Scholar 

  3. Ozols RF, Bundy BN, Greer BE et al (2003) Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: a Gynecologic Oncology Group study. J Clin Oncol 21:3194–3200

    Article  CAS  Google Scholar 

  4. Vergote I, Tropé CG, Amant F et al (2010) Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med 363:943–953

    Article  CAS  Google Scholar 

  5. Kehoe S, Hook J, Nankivell M et al (2015) Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet 386:249–257

    Article  Google Scholar 

  6. Fagotti A, Ferrandina G, Vizzielli G et al (2016) Phase III randomised clinical trial comparing primary surgery vs. neoadjuvant chemotherapy in advanced epithelial ovarian cancer with high tumour load (SCORPION trial): final analysis of peri-operative outcome. Eur J Cancer 59:22–33

    Article  Google Scholar 

  7. Onda T, Satoh T, Saito T et al (2016) Comparison of treatment invasiveness between upfront debulking surgery versus interval debulking surgery following neoadjuvant chemotherapy for stage III/IV ovarian, tubal, and peritoneal cancers in a phase III randomised trial: Japan Clinical Oncology Group Study JCOG0602. Eur J Cancer 64:22–31

    Article  Google Scholar 

  8. Vergote I, Coens C, Nankivell M et al (2018) Neoadjuvant chemotherapy versus debulking surgery in advanced tubo-ovarian cancers: pooled analysis of individual patient data from the EORTC 55971 and CHORUS trials. Lancet Oncol 19:1680–1687

    Article  Google Scholar 

  9. Norton L (2001) Theoretical concepts and the emerging role of taxanes in adjuvant therapy. Oncologist 6:30–35

    Article  CAS  Google Scholar 

  10. Katsumata N, Yasuda M, Takahashi F et al (2009) Dose-dense paclitaxel once a week in combination with carboplatin every 3 weeks for advanced ovarian cancer: a phase 3, open-label, randomised controlled trial. Lancet 374:1331–1338

    Article  CAS  Google Scholar 

  11. Katsumata N, Yasuda M, Isonishi S et al (2013) Long-term results of dose-dense paclitaxel and carboplatin versus conventional paclitaxel and carboplatin for treatment of advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer (JGOG 3016): a randomised, controlled, open-label trial. Lancet Oncol 14:1020–1026

    Article  CAS  Google Scholar 

  12. Becker DA, Thomas ED, Gilbert AL et al (2016) Improved outcomes with dose-dense paclitaxel-based neoadjuvant chemotherapy in advanced epithelial ovarian carcinoma. Gynecol Oncol 142:25–29

    Article  CAS  Google Scholar 

  13. Ebata T, Yunokawa M, Bun S et al (2016) Dose-dense paclitaxel plus carboplatin as neoadjuvant chemotherapy for advanced ovarian, fallopian tube, or primary peritoneal carcinomas. Cancer Chemother Pharmacol 78:1283–1288

    Article  CAS  Google Scholar 

  14. Yoshihama T, Nomura H, Iwasa N et al (2017) Efficacy and safety of dose-dense paclitaxel plus carboplatin as neoadjuvant chemotherapy for advanced ovarian, fallopian tube or peritoneal cancer. Jpn J Clin Oncol 47:1019–1023

    Article  Google Scholar 

  15. Eisenhauer EA, Therasse P, Bogaerts J et al (2013) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247

    Article  Google Scholar 

  16. Kanda Y (2013) Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transpl 48:452–458

    Article  CAS  Google Scholar 

  17. Chan JK, Brady MF, Penson RT et al (2016) Weekly vs. every-3-week paclitaxel and carboplatin for ovarian cancer. N Engl J Med 374:738–748

    Article  CAS  Google Scholar 

  18. Pignata S, Scambia G, Katsaros D et al (2014) Carboplatin plus paclitaxel once a week versus every 3 weeks in patients with advanced ovarian cancer (MITO-7): a randomised, multicentre, open-label, phase 3 trial. Lancet Oncol 15:396–405

    Article  CAS  Google Scholar 

  19. Lee MX, Tan DS (2018) Weekly versus 3-weekly paclitaxel in combination with carboplatin in advanced ovarian cancer: which is the optimal adjuvant chemotherapy regimen? J Gynecol Oncol 29:e96

    Article  CAS  Google Scholar 

  20. Burger RA, Brady MF, Bookman MA et al (2011) Gynecologic oncology group, incorporation of bevacizumab in the primary treatment of ovarian cancer. N Engl J Med 365:2473–2483

    Article  CAS  Google Scholar 

  21. Rouzier R, Gouy S, Selle F et al (2017) Efficacy and safety of bevacizumab-containing neoadjuvant therapy followed by interval debulking surgery in advanced ovarian cancer: results from the ANTHALYA trial. Eur J Cancer 70:133–142

    Article  CAS  Google Scholar 

  22. Komiyama S, Kugimiya T, Kubushiro K (2018) Safety and efficacy of neoadjuvant chemotherapy containing bevacizumab and interval debulking surgery for advanced epithelial ovarian cancer: a feasibility study. J Surg Oncol 118:687–693

    Article  CAS  Google Scholar 

  23. Xu X, Deng F, Lv M et al (2017) The number of cycles of neoadjuvant chemotherapy is associated with prognosis of stage IIIc–IV high-grade serous ovarian cancer. Arch Gynecol Obstet 295:451–458

    Article  CAS  Google Scholar 

  24. Colombo PE, Labaki M, Fabbro M et al (2014) Impact of neoadjuvant chemotherapy cycles prior to interval surgery in patients with advanced epithelial ovarian cancer. Gynecol Oncol 135:223–230

    Article  CAS  Google Scholar 

  25. Bogani G, Matteucci L, Tamberi S et al (2017) The impact of number of cycles of neoadjuvant chemotherapy on survival of patients undergoing interval debulking surgery for stage IIIC-IV unresectable ovarian cancer results from a multi-institutional study. Int J Gynecol Cancer 27:1856–1862

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

TS designed the study, analyzed the data, and wrote the initial draft of the manuscript. SN contributed to design of the research, analysis and interpretation of the data, and assisted in the preparation of the manuscript. KS, MK, KY, TJ, HY, MK, TS, KM, TS, and SY have contributed to data collection and interpretation, and critically reviewed the manuscript. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Shoji Nagao.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Institutional Review Board of the Hyogo Cancer Center (Hyogo, Japan).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shibutani, T., Nagao, S., Suzuki, K. et al. Dose-dense paclitaxel and carboplatin vs. conventional paclitaxel and carboplatin as neoadjuvant chemotherapy for advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer: a retrospective study. Int J Clin Oncol 25, 502–507 (2020). https://doi.org/10.1007/s10147-019-01567-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10147-019-01567-y

Keywords

Navigation