Prolonged Paclitaxel Infusion Does Not Improve Outcomes in Ovarian Cancer

NEW YORK OCT 31, 2007(Reuters Health) - Prolonging the infusion of paclitaxel from 24 to 96 hours does not significantly improve outcomes in women with suboptimal stage III or IV epithelial ovarian cancer (EOC), according to a report in the October 1st issue of the Journal of Clinical Oncology.

Previous studies and pharmacokinetic models suggested that longer infusions could achieve responses in some patients who were resistant to shorter paclitaxel infusions, the authors explain.

Dr. David R. Spriggs from Memorial Sloan-Kettering Cancer Center, New York and associates compared the efficacy of continuous infusion of paclitaxel during 96 hours with that of standard paclitaxel infusion over 24 hours (both followed by cisplatin) in six cycles, in a phase III study involving 293 women with stage IV EOC or suboptimally debulked stage III EOC.

Overall treatment-related toxicity did not differ between the two treatment schedules, the investigators report, and similar proportions of patients with clinically measurable disease at study enrollment achieved complete or partial remissions.

Median progression-free survival was 1.03 years and median overall survival was 2.49 years in the 24-hour infusion group, compared with 1.05 years and 2.54 years, respectively, in the 96-hour infusion group. These differences were not statistically significant.

"The evidence from this study supports the hypothesis that the combination of cisplatin and 96-hour paclitaxel infusion is not superior to cisplatin and 24-hour paclitaxel, and the complexity of a 96-hour infusion cannot be justified by outcome," the investigators conclude.

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