Paclitaxel (Taxol)/carboplatin combination chemotherapy in the treatment of advanced ovarian cancer.

The activity of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) in advanced ovarian cancer, both as a single agent and in combination chemotherapy, has been demonstrated in numerous phase I/II trials. Paclitaxel/platinum combinations have produced encouraging results in phase III trials and are now considered standard therapy for advanced disease. Carboplatin, an effective but more tolerable analog of cisplatin, has been substituted for cisplatin to reduce the toxicity of the paclitaxel/cisplatin regimen. A recent phase III equivalency trial of the Gynecologic Oncology Group (GOG 158) was conducted to rigorously compare paclitaxel/carboplatin with paclitaxel/cisplatin in the treatment of optimal stage III ovarian cancer. In a preliminary analysis of this trial, paclitaxel/carboplatin was better tolerated with no apparent difference in efficacy from paclitaxel/cisplatin. The improved toxicity profile and equivalent activity of paclitaxel/carboplatin also are suggested by preliminary results from other phase III trials. The results indicate that paclitaxel/carboplatin has a higher therapeutic index and is preferred over paclitaxel/cisplatin for advanced ovarian cancer.