PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of brjcancerBJC HomepageBJC Advance online publicationBJC Current IssueSubmitting an article to BJCWeb feeds
 
Br J Cancer. 1998 December; 78(11): 1479–1487.
PMCID: PMC2063202

Chemotherapy in advanced ovarian cancer: four systematic meta-analyses of individual patient data from 37 randomized trials. Advanced Ovarian Cancer Trialists' Group.

Abstract

The purpose of this systematic study was to provide an up to date and reliable quantitative summary of the relative benefits of various types of chemotherapy (non-platinum vs platinum, single-agent vs combination and carboplatin vs cisplatin) in the treatment of advanced ovarian cancer. Also, to investigate whether well-defined patient subgroups benefit more or less from cisplatin- or carboplatin-based therapy. Meta-analyses were based on updated individual patient data from all available randomized controlled trials (published and unpublished), including 37 trials, 5667 patients and 4664 deaths. The results suggest that platinum-based chemotherapy is better than non-platinum therapy, show a trend in favour of platinum combinations over single-agent platinum, and suggest that cisplatin and carboplatin are equally effective. There is no good evidence that cisplatin is more or less effective than carboplatin in any particular subgroup of patients.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.3M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Click on the image to see a larger version.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Adams M, Kerby IJ, Rocker I, Evans A, Johansen K, Franks CR. A comparison of the toxicity and efficacy of cisplatin and carboplatin in advanced ovarian cancer. The Swons Gynaecological Cancer Group. Acta Oncol. 1989;28(1):57–60. [PubMed]
  • Alberts DS, Green S, Hannigan EV, O'Toole R, Stock-Novack D, Anderson P, Surwit EA, Malvlya VK, Nahhas WA, Jolles CJ. Improved therapeutic index of carboplatin plus cyclophosphamide versus cisplatin plus cyclophosphamide: final report by the Southwest Oncology Group of a phase III randomized trial in stages III and IV ovarian cancer. J Clin Oncol. 1992 May;10(5):706–717. [PubMed]
  • Anderson H, Wagstaff J, Crowther D, Swindell R, Lind MJ, McGregor J, Timms MS, Brown D, Palmer P. Comparative toxicity of cisplatin, carboplatin (CBDCA) and iproplatin (CHIP) in combination with cyclophosphamide in patients with advanced epithelial ovarian cancer. Eur J Cancer Clin Oncol. 1988 Sep;24(9):1471–1479. [PubMed]
  • Bajorin DF, Sarosdy MF, Pfister DG, Mazumdar M, Motzer RJ, Scher HI, Geller NL, Fair WR, Herr H, Sogani P, et al. Randomized trial of etoposide and cisplatin versus etoposide and carboplatin in patients with good-risk germ cell tumors: a multiinstitutional study. J Clin Oncol. 1993 Apr;11(4):598–606. [PubMed]
  • Bell DR, Woods RL, Levi JA, Fox RM, Tattersall MH. Advanced ovarian cancer: a prospective randomised trial of chlorambucil versus combined cyclophosphamide and cis-diamminedichloroplatinum. Aust N Z J Med. 1982 Jun;12(3):245–249. [PubMed]
  • Carmo-Pereira J, Costa FO, Henriques E. cis-Platinum, adriamycin, and hexamethylmelamine versus cyclophosphamide in advanced ovarian carcinoma. Cancer Chemother Pharmacol. 1983;10(2):100–103. [PubMed]
  • Chalmers I, Haynes B. Reporting, updating, and correcting systematic reviews of the effects of health care. BMJ. 1994 Oct 1;309(6958):862–865. [PMC free article] [PubMed]
  • Cohen CJ, Goldberg JD, Holland JF, Bruckner HW, Deppe G, Gusberg SB, Wallach RC, Kabakow B, Rodin J. Improved therapy with cisplatin regimens for patients with ovarian carcinoma (FIGO Stages III and IV) as measured by surgical end-staging (second-look operation). Am J Obstet Gynecol. 1983 Apr 15;145(8):955–967. [PubMed]
  • Conte PF, Bruzzone M, Carnino F, Chiara S, Donadio M, Facchini V, Fioretti P, Foglia G, Gadducci A, Gallo L, et al. Carboplatin, doxorubicin, and cyclophosphamide versus cisplatin, doxorubicin, and cyclophosphamide: a randomized trial in stage III-IV epithelial ovarian carcinoma. J Clin Oncol. 1991 Apr;9(4):658–663. [PubMed]
  • de Oliveira CF, Lacave AJ, Villani C, Wolff JP, di Re F, Namer M, Maskens A, George M, Dalesio O, Rotmensz N, et al. Randomized comparison of cyclophosphamide, doxorubicin and cisplatin (CAP) versus cyclophosphamide and doxorubicin (CA) for the treatment of advanced ovarian cancer (ADOVCA). A EORTC Gynecological Cancer Cooperative Group Study. Eur J Gynaecol Oncol. 1990;11(5):323–330. [PubMed]
  • Edmonson JH, McCormack GM, Wieand HS, Kugler JW, Krook JE, Stanhope CR, Everson LK, Laurie JA, Ebbert LP, Malkasian GD, et al. Cyclophosphamide-cisplatin versus cyclophosphamide-carboplatin in stage III-IV ovarian carcinoma: a comparison of equally myelosuppressive regimens. J Natl Cancer Inst. 1989 Oct 4;81(19):1500–1504. [PubMed]
  • Freedman LS. Tables of the number of patients required in clinical trials using the logrank test. Stat Med. 1982 Apr-Jun;1(2):121–129. [PubMed]
  • Kato T, Nishimura H, Yamabe T, Terashima Y, Kasamatsu T, Hirabayashi K, Nishiya I, Yajima A, Takamizawa H, Tsutsui F, et al. [Phase III study of carboplatin in ovarian cancer]. Gan To Kagaku Ryoho. 1988 Aug;15(8):2297–2304. [PubMed]
  • Leonard RC, Smart GE, Livingstone JR, Cornbleet MA, Kerr GR, Fletcher S, Webb JN, Smyth JF. Randomised trial comparing prednimustine with combination chemotherapy in advanced ovarian carcinoma. Cancer Chemother Pharmacol. 1989;23(2):105–110. [PubMed]
  • Masding J, Sarkar TK, White WF, Barley VL, Chawla SL, Boesen E, Rostom AY, Menday AP. Intravenous treosulfan versus intravenous treosulfan plus cisplatinum in advanced ovarian carcinoma. Br J Obstet Gynaecol. 1990 Apr;97(4):342–351. [PubMed]
  • Omura G, Blessing JA, Ehrlich CE, Miller A, Yordan E, Creasman WT, Homesley HD. A randomized trial of cyclophosphamide and doxorubicin with or without cisplatin in advanced ovarian carcinoma. A Gynecologic Oncology Group Study. Cancer. 1986 May 1;57(9):1725–1730. [PubMed]
  • Rankin EM, Mill L, Kaye SB, Atkinson R, Cassidy L, Cordiner J, Cruickshank D, Davis J, Duncan ID, Fullerton W, et al. A randomised study comparing standard dose carboplatin with chlorambucil and carboplatin in advanced ovarian cancer. Br J Cancer. 1992 Feb;65(2):275–281. [PMC free article] [PubMed]
  • Skarlos DV, Aravantinos G, Kosmidis P, Pavlidis N, Gennatas K, Beer M, Mylonakis N, Makrantonakis P, Klouvas G, Karpathios S, et al. Carboplatin alone compared with its combination with epirubicin and cyclophosphamide in untreated advanced epithelial ovarian cancer: a Hellenic co-operative oncology group study. Eur J Cancer. 1996 Mar;32A(3):421–428. [PubMed]
  • Swenerton K, Jeffrey J, Stuart G, Roy M, Krepart G, Carmichael J, Drouin P, Stanimir R, O'Connell G, MacLean G, et al. Cisplatin-cyclophosphamide versus carboplatin-cyclophosphamide in advanced ovarian cancer: a randomized phase III study of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol. 1992 May;10(5):718–726. [PubMed]
  • Taylor AE, Wiltshaw E, Gore ME, Fryatt I, Fisher C. Long-term follow-up of the first randomized study of cisplatin versus carboplatin for advanced epithelial ovarian cancer. J Clin Oncol. 1994 Oct;12(10):2066–2070. [PubMed]
  • ten Bokkel Huinink WW, van der Burg ME, van Oosterom AT, Neijt JP, George M, Guastalla JP, Veenhof CH, Rotmensz N, Dalesio O, Vermorken JB. Carboplatin in combination therapy for ovarian cancer. Cancer Treat Rev. 1988 Jun;15 (Suppl B):9–15. [PubMed]
  • Tomirotti M, Perrone S, Giè P, Canaletti R, Carpi A, Biasoli R, Lombardi F, Giovanninetti A, Mensi F, Villa S, et al. Cisplatin (P) versus cyclophosphamide, adriamycin and cisplatin (CAP) for stage III-IV epithelial ovarian carcinoma: a prospective randomized trial. Tumori. 1988 Oct 31;74(5):573–577. [PubMed]
  • Wadler S, Yeap B, Vogl S, Carbone P. Randomized trial of initial therapy with melphalan versus cisplatin-based combination chemotherapy in patients with advanced ovarian carcinoma: initial and long term results--Eastern Cooperative Oncology Group Study E2878. Cancer. 1996 Feb 15;77(4):733–742. [PubMed]
  • Wilbur DW, Rentschler RE, Wagner RJ, Keeney ED, King A, Hilliard DA. Randomized trial of the addition of cis-platin (DDP) and/or BCG to cyclophosphamide (CTX) chemotherapy for ovarian carcinoma. J Surg Oncol. 1987 Mar;34(3):165–169. [PubMed]
  • Williams CJ, Mead GM, Macbeth FR, Thompson J, Whitehouse JM, MacDonald H, Harvey VJ, Slevin ML, Lister TA, Shepherd JH, et al. Cisplatin combination chemotherapy versus chlorambucil in advanced ovarian carcinoma: mature results of a randomized trial. J Clin Oncol. 1985 Nov;3(11):1455–1462. [PubMed]
  • Wiltshaw E, Evans B, Rustin G, Gilbey E, Baker J, Barker G. A prospective randomized trial comparing high-dose cisplatin with low-dose cisplatin and chlorambucil in advanced ovarian carcinoma. J Clin Oncol. 1986 May;4(5):722–729. [PubMed]
  • Yusuf S, Peto R, Lewis J, Collins R, Sleight P. Beta blockade during and after myocardial infarction: an overview of the randomized trials. Prog Cardiovasc Dis. 1985 Mar-Apr;27(5):335–371. [PubMed]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK