The combination of paclitaxel and platinum may produce a modest but important survival benefit for women with relapsed ovarian cancer compared with platinum chemotherapy alone, according to an article in the June 21st issue of the Lancet.

Ovarian cancer is the fourth most common cancer among women and causes over 100,000 deaths worldwide every year. Although treatment has improved over the past three decades (involving surgery and platinum-based chemotherapy), most women still relapse and die of the disease within 5 years. There is currently no first-choice treatment for relapse of ovarian cancer.

Around 800 women who had initially responded to platinum-based chemotherapy and whose ovarian cancer later relapsed were enrolled in 119 European centers. Patients were randomly assigned paclitaxel and platinum chemotherapy or conventional platinum chemotherapy. Carboplatin was the most common platinum agent.

After 3.5 years follow-up, women assigned combination therapy had a modest survival benefit compared with those who received only platinum (2-year survival rates were 57 percent versus 50 percent). Women given combination treatment survived for an average of 5 months more (29 months total) compared with women on platinum therapy alone. Self-reported quality of life assessments showed no differences between the 2 groups.

Lead UK investigator Jonathan Ledermann commented, "Our findings show a beneficial effect for paclitaxel in combination with platinum chemotherapy on survival and progression-free survival among patients with platinum-sensitive relapsed ovarian cancer. Paclitaxel was most frequently combined with carboplatin, and the most common conventional platinum-based chemotherapy used was single-agent carboplatin. We believe, therefore, that all women who relapse more than 6 months after the completion of previous platinum-based chemotherapy should be considered for combination chemotherapy with platinum and paclitaxel, even if they received paclitaxel as part of their first-line treatment."