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Nov. 15, 2006 -- Aggressive combination therapy for ovarian cancer is worth the cost and toxicity, a new study shows.
The new treatment more than doubles survival time from two and a half years to five and a half years.
Ovarian cancercancer is a killer. It's often well advanced by the time it's diagnosed. Without treatment, most patients die in two and a half years.
In patients who can tolerate it, doctors today use a combination of platinum-based chemotherapy plus drugs called taxanes. Most recently, they've begun injecting the drugs directly into the abdominal cavity.
It seems to work better than older treatments. But might less aggressive therapy work just as well? A team of researchers from Britain, Greece, and the U.S. decided to find out.
Maria Kyrgiou, MD, of Queen Charlotte's and Chelsea Hospital in London, and colleagues analyzed 198 clinical studies. The studies, conducted between 1971 and 2006, tested 120 different chemotherapy regimens on 38,440 women with ovarian cancer.
The bottom line: Compared with single-agent chemotherapy without platinum-based drugs or taxanes, the new combination -- given by abdominal injection -- cuts the risk of death by more than half (55%). When given in other ways, the combination cuts death risk by 42%.
Platinum-based drug combinations without taxanes cut deaths by 40% when given by abdominal injection and by 30% when given in other ways. Taxanes alone don't do much good.
"Compared with the early days, when neither platinum nor taxanes were available and chemotherapy was clearly no better than supportive care [in terms of death] ... survival can now be more than doubled using currently available regimens," Kyrgiou and colleagues conclude.
The researchers note that not all patients will be able to tolerate aggressive combination therapy.
"These benefits should be tailored to the individual patient and balanced against tolerability," they warn.
Kyrgiou and colleagues report their findings in the Nov. 15 issue of the Journal of the National Cancer Institute.
SOURCE: Kyrgiou, M. Journal of the National Cancer Institute, Nov. 15, 2006; vol 98: pp 1655-1663.