Review of studies administering weekly and 3‐weekly regimens of paclitaxel and carboplatin.
| Reference . | No. of patients . | Study type . | Regimen . | Paclitaxel dose, mg/m2 . | Carboplatin dose, AUC . | Cycle length, d . | No. of cycles . | Median OS; 95% CI, mo . | Median PFS; 95% CI, mo . | Grade 3–4 toxicity (unless specified) . | Conclusions . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Current study | 707 | Retrospective | 3W | 175 | 6 | 21 | 6 | 54.0 (48.4–65.7) | 13.2 (11.6–16.6) | Anemia: 5%; neutropenia: 7%; thrombocytopenia: 7%; neuropathya: 6% (neuropathya grade 2–4: 31%) | PC‐W administered in a 28‐day cycle improved PFS and OS and had better tolerability when compared retrospectively with the standard PC‐3W |
| W | 80 | 2 | 28 | 6 | 75.2 (68.4–86.4) | 21.4 (18.8–24.2) | Anemia: 13%; neutropenia: 19%; thrombocytopenia: 10%; neuropathya: 2% (neuropathya grade 2–4: 21%) | ||||
| Chan et al., 2016 [13]; GOG‐0262 | 692 | Prospective, randomized | 3W | 175 | 6 | 21 | 6 | 39.0 | 14.0 (10.3 without bevazicumab) | Anemia: 16%; neutropenia:83%; neuropathya (grade 2–4): 18% | Among patients who did not receive bevacizumab, PC‐W was associated with a median PFS that was 3.9 months longer than that observed with PC‐3W |
| W | 80 | 6 | 21 | 6 | 40.2 | 14.7 (14.2 without bevazicumab) | Anemia: 36% neutropenia:72%; neuropathya (grade 2–4): 26% | ||||
| Katsumata et al., 2009 [15,]; Katsumata et al., 2013 [14]; JGOG 3016 | 600 | Prospective, randomized | 3W | 180 | 6 | 21 | 6 | 62.2 (52.1–82·6) | 17.5 (15.7–21.7) | Anemia: 44%; neutropenia: 88%; thrombocytopenia: 38%; neuropathya: 6% | Dose‐dense treatment offers better survival than conventional treatment |
| W | 80 | 6 | 21 | 6 | 100.5 (65.2–not reached) | 28.2 (22.3–33.8) | Anemia: 69%; neutropenia: 92%; thrombocytopenia: 38%; neuropathya: 7% | ||||
| Clamp et al., 2017 [18]; ICON‐8 | 1,566 | Prospective, randomized | 3W | 175 | 5/6 | 21 | 6 | 24.4 | All grade 3–4 toxicities: 42% | No benefit to any regimen | |
| W | 80 | 5/6 | 21 | 6 | 24.9 | All grade 3–4 toxicities: 42% | |||||
| W | 80 | 2 | 21 | 6 | 25.3 | All grade 3–4 toxicities: 42% | |||||
| Pignata et al., 2014 [16]; MITO‐7 | 810 | Prospective, randomized | 3W | 175 | 6 | 21 | 6 | 17.3 (15.2–20.2) | Neutropenia: 50%; thrombocytopenia: 7%; neuropathya grade 2–4): 17% | PC‐W improved quality of life and showed a better toxicity profile, but did not prolong PFS | |
| W | 60 | 2 | 21 | 6 | 18.3 (16.8–20.9) | Neutropenia: 42%; thrombocytopenia: 1%; neuropathya (Grade 2–4): 6% | |||||
| Abaid et al., 2013 [28] | 88 | Prospective | W | 80 | 5/6 | 28 | 6 | 31.5 | 22.5 | Neutropenia: 22.7 %; thrombocytopenia: 7.9 %; anemia: 1.1 % | Modified dose‐dense PC‐W preserves the efficacy of traditional dose‐dense chemotherapy, while minimizing hematologic toxicity |
| Ebata et al., 2016 [29] | 74 | Retrospective | W | 80 | 6 | 21 | 6 | 55.1 (44.6–not reached) | 19.0 (16.2–23.7) | Anemia: 41.9%; neutropenia: 55.4%; thrombocytopenia: 21.6%; neuropathya: 8.1% | Dose‐dense carboplatin + paclitaxel was effective and tolerable |
| Van der Burg et al., 2014 [30] | 267 | Prospective, randomized | 3W | 175 | 6 | 21 | 6 | 41.1 (34.4–47.7) | 16.4 (13.5–19.2) | Anemia: 3%; neutropenia: 38.2%; thrombocytopenia: 3%; neuropathya: none | There was no benefit in terms of OS, PFS, or RR for a weekly regimen nor for extended chemotherapy as first‐line treatment for EOC in European patients |
| W | 90 | 4 | 28 | 6 | 44.8 (33.1–56.5) | 18.5 (15.9–21) | Anemia: 13.5%; neutropenia: 61.2; thrombocytopenia: 11.4%; neuropathya: 1.5% |
| Reference . | No. of patients . | Study type . | Regimen . | Paclitaxel dose, mg/m2 . | Carboplatin dose, AUC . | Cycle length, d . | No. of cycles . | Median OS; 95% CI, mo . | Median PFS; 95% CI, mo . | Grade 3–4 toxicity (unless specified) . | Conclusions . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Current study | 707 | Retrospective | 3W | 175 | 6 | 21 | 6 | 54.0 (48.4–65.7) | 13.2 (11.6–16.6) | Anemia: 5%; neutropenia: 7%; thrombocytopenia: 7%; neuropathya: 6% (neuropathya grade 2–4: 31%) | PC‐W administered in a 28‐day cycle improved PFS and OS and had better tolerability when compared retrospectively with the standard PC‐3W |
| W | 80 | 2 | 28 | 6 | 75.2 (68.4–86.4) | 21.4 (18.8–24.2) | Anemia: 13%; neutropenia: 19%; thrombocytopenia: 10%; neuropathya: 2% (neuropathya grade 2–4: 21%) | ||||
| Chan et al., 2016 [13]; GOG‐0262 | 692 | Prospective, randomized | 3W | 175 | 6 | 21 | 6 | 39.0 | 14.0 (10.3 without bevazicumab) | Anemia: 16%; neutropenia:83%; neuropathya (grade 2–4): 18% | Among patients who did not receive bevacizumab, PC‐W was associated with a median PFS that was 3.9 months longer than that observed with PC‐3W |
| W | 80 | 6 | 21 | 6 | 40.2 | 14.7 (14.2 without bevazicumab) | Anemia: 36% neutropenia:72%; neuropathya (grade 2–4): 26% | ||||
| Katsumata et al., 2009 [15,]; Katsumata et al., 2013 [14]; JGOG 3016 | 600 | Prospective, randomized | 3W | 180 | 6 | 21 | 6 | 62.2 (52.1–82·6) | 17.5 (15.7–21.7) | Anemia: 44%; neutropenia: 88%; thrombocytopenia: 38%; neuropathya: 6% | Dose‐dense treatment offers better survival than conventional treatment |
| W | 80 | 6 | 21 | 6 | 100.5 (65.2–not reached) | 28.2 (22.3–33.8) | Anemia: 69%; neutropenia: 92%; thrombocytopenia: 38%; neuropathya: 7% | ||||
| Clamp et al., 2017 [18]; ICON‐8 | 1,566 | Prospective, randomized | 3W | 175 | 5/6 | 21 | 6 | 24.4 | All grade 3–4 toxicities: 42% | No benefit to any regimen | |
| W | 80 | 5/6 | 21 | 6 | 24.9 | All grade 3–4 toxicities: 42% | |||||
| W | 80 | 2 | 21 | 6 | 25.3 | All grade 3–4 toxicities: 42% | |||||
| Pignata et al., 2014 [16]; MITO‐7 | 810 | Prospective, randomized | 3W | 175 | 6 | 21 | 6 | 17.3 (15.2–20.2) | Neutropenia: 50%; thrombocytopenia: 7%; neuropathya grade 2–4): 17% | PC‐W improved quality of life and showed a better toxicity profile, but did not prolong PFS | |
| W | 60 | 2 | 21 | 6 | 18.3 (16.8–20.9) | Neutropenia: 42%; thrombocytopenia: 1%; neuropathya (Grade 2–4): 6% | |||||
| Abaid et al., 2013 [28] | 88 | Prospective | W | 80 | 5/6 | 28 | 6 | 31.5 | 22.5 | Neutropenia: 22.7 %; thrombocytopenia: 7.9 %; anemia: 1.1 % | Modified dose‐dense PC‐W preserves the efficacy of traditional dose‐dense chemotherapy, while minimizing hematologic toxicity |
| Ebata et al., 2016 [29] | 74 | Retrospective | W | 80 | 6 | 21 | 6 | 55.1 (44.6–not reached) | 19.0 (16.2–23.7) | Anemia: 41.9%; neutropenia: 55.4%; thrombocytopenia: 21.6%; neuropathya: 8.1% | Dose‐dense carboplatin + paclitaxel was effective and tolerable |
| Van der Burg et al., 2014 [30] | 267 | Prospective, randomized | 3W | 175 | 6 | 21 | 6 | 41.1 (34.4–47.7) | 16.4 (13.5–19.2) | Anemia: 3%; neutropenia: 38.2%; thrombocytopenia: 3%; neuropathya: none | There was no benefit in terms of OS, PFS, or RR for a weekly regimen nor for extended chemotherapy as first‐line treatment for EOC in European patients |
| W | 90 | 4 | 28 | 6 | 44.8 (33.1–56.5) | 18.5 (15.9–21) | Anemia: 13.5%; neutropenia: 61.2; thrombocytopenia: 11.4%; neuropathya: 1.5% |
Randomized studies are shown in bold.
aPeripheral sensory neuropathy.
Abbreviations: CI, confidence Interval; EOC, epithelial ovarian cancer; OS, overall survival; PC‐W, weekly paclitaxel and carboplatin regimen; PC‐3W, three‐weekly paclitaxel and carboplatin regimen; PFS, progression‐free survival; RR, response rate.
Review of studies administering weekly and 3‐weekly regimens of paclitaxel and carboplatin.
| Reference . | No. of patients . | Study type . | Regimen . | Paclitaxel dose, mg/m2 . | Carboplatin dose, AUC . | Cycle length, d . | No. of cycles . | Median OS; 95% CI, mo . | Median PFS; 95% CI, mo . | Grade 3–4 toxicity (unless specified) . | Conclusions . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Current study | 707 | Retrospective | 3W | 175 | 6 | 21 | 6 | 54.0 (48.4–65.7) | 13.2 (11.6–16.6) | Anemia: 5%; neutropenia: 7%; thrombocytopenia: 7%; neuropathya: 6% (neuropathya grade 2–4: 31%) | PC‐W administered in a 28‐day cycle improved PFS and OS and had better tolerability when compared retrospectively with the standard PC‐3W |
| W | 80 | 2 | 28 | 6 | 75.2 (68.4–86.4) | 21.4 (18.8–24.2) | Anemia: 13%; neutropenia: 19%; thrombocytopenia: 10%; neuropathya: 2% (neuropathya grade 2–4: 21%) | ||||
| Chan et al., 2016 [13]; GOG‐0262 | 692 | Prospective, randomized | 3W | 175 | 6 | 21 | 6 | 39.0 | 14.0 (10.3 without bevazicumab) | Anemia: 16%; neutropenia:83%; neuropathya (grade 2–4): 18% | Among patients who did not receive bevacizumab, PC‐W was associated with a median PFS that was 3.9 months longer than that observed with PC‐3W |
| W | 80 | 6 | 21 | 6 | 40.2 | 14.7 (14.2 without bevazicumab) | Anemia: 36% neutropenia:72%; neuropathya (grade 2–4): 26% | ||||
| Katsumata et al., 2009 [15,]; Katsumata et al., 2013 [14]; JGOG 3016 | 600 | Prospective, randomized | 3W | 180 | 6 | 21 | 6 | 62.2 (52.1–82·6) | 17.5 (15.7–21.7) | Anemia: 44%; neutropenia: 88%; thrombocytopenia: 38%; neuropathya: 6% | Dose‐dense treatment offers better survival than conventional treatment |
| W | 80 | 6 | 21 | 6 | 100.5 (65.2–not reached) | 28.2 (22.3–33.8) | Anemia: 69%; neutropenia: 92%; thrombocytopenia: 38%; neuropathya: 7% | ||||
| Clamp et al., 2017 [18]; ICON‐8 | 1,566 | Prospective, randomized | 3W | 175 | 5/6 | 21 | 6 | 24.4 | All grade 3–4 toxicities: 42% | No benefit to any regimen | |
| W | 80 | 5/6 | 21 | 6 | 24.9 | All grade 3–4 toxicities: 42% | |||||
| W | 80 | 2 | 21 | 6 | 25.3 | All grade 3–4 toxicities: 42% | |||||
| Pignata et al., 2014 [16]; MITO‐7 | 810 | Prospective, randomized | 3W | 175 | 6 | 21 | 6 | 17.3 (15.2–20.2) | Neutropenia: 50%; thrombocytopenia: 7%; neuropathya grade 2–4): 17% | PC‐W improved quality of life and showed a better toxicity profile, but did not prolong PFS | |
| W | 60 | 2 | 21 | 6 | 18.3 (16.8–20.9) | Neutropenia: 42%; thrombocytopenia: 1%; neuropathya (Grade 2–4): 6% | |||||
| Abaid et al., 2013 [28] | 88 | Prospective | W | 80 | 5/6 | 28 | 6 | 31.5 | 22.5 | Neutropenia: 22.7 %; thrombocytopenia: 7.9 %; anemia: 1.1 % | Modified dose‐dense PC‐W preserves the efficacy of traditional dose‐dense chemotherapy, while minimizing hematologic toxicity |
| Ebata et al., 2016 [29] | 74 | Retrospective | W | 80 | 6 | 21 | 6 | 55.1 (44.6–not reached) | 19.0 (16.2–23.7) | Anemia: 41.9%; neutropenia: 55.4%; thrombocytopenia: 21.6%; neuropathya: 8.1% | Dose‐dense carboplatin + paclitaxel was effective and tolerable |
| Van der Burg et al., 2014 [30] | 267 | Prospective, randomized | 3W | 175 | 6 | 21 | 6 | 41.1 (34.4–47.7) | 16.4 (13.5–19.2) | Anemia: 3%; neutropenia: 38.2%; thrombocytopenia: 3%; neuropathya: none | There was no benefit in terms of OS, PFS, or RR for a weekly regimen nor for extended chemotherapy as first‐line treatment for EOC in European patients |
| W | 90 | 4 | 28 | 6 | 44.8 (33.1–56.5) | 18.5 (15.9–21) | Anemia: 13.5%; neutropenia: 61.2; thrombocytopenia: 11.4%; neuropathya: 1.5% |
| Reference . | No. of patients . | Study type . | Regimen . | Paclitaxel dose, mg/m2 . | Carboplatin dose, AUC . | Cycle length, d . | No. of cycles . | Median OS; 95% CI, mo . | Median PFS; 95% CI, mo . | Grade 3–4 toxicity (unless specified) . | Conclusions . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Current study | 707 | Retrospective | 3W | 175 | 6 | 21 | 6 | 54.0 (48.4–65.7) | 13.2 (11.6–16.6) | Anemia: 5%; neutropenia: 7%; thrombocytopenia: 7%; neuropathya: 6% (neuropathya grade 2–4: 31%) | PC‐W administered in a 28‐day cycle improved PFS and OS and had better tolerability when compared retrospectively with the standard PC‐3W |
| W | 80 | 2 | 28 | 6 | 75.2 (68.4–86.4) | 21.4 (18.8–24.2) | Anemia: 13%; neutropenia: 19%; thrombocytopenia: 10%; neuropathya: 2% (neuropathya grade 2–4: 21%) | ||||
| Chan et al., 2016 [13]; GOG‐0262 | 692 | Prospective, randomized | 3W | 175 | 6 | 21 | 6 | 39.0 | 14.0 (10.3 without bevazicumab) | Anemia: 16%; neutropenia:83%; neuropathya (grade 2–4): 18% | Among patients who did not receive bevacizumab, PC‐W was associated with a median PFS that was 3.9 months longer than that observed with PC‐3W |
| W | 80 | 6 | 21 | 6 | 40.2 | 14.7 (14.2 without bevazicumab) | Anemia: 36% neutropenia:72%; neuropathya (grade 2–4): 26% | ||||
| Katsumata et al., 2009 [15,]; Katsumata et al., 2013 [14]; JGOG 3016 | 600 | Prospective, randomized | 3W | 180 | 6 | 21 | 6 | 62.2 (52.1–82·6) | 17.5 (15.7–21.7) | Anemia: 44%; neutropenia: 88%; thrombocytopenia: 38%; neuropathya: 6% | Dose‐dense treatment offers better survival than conventional treatment |
| W | 80 | 6 | 21 | 6 | 100.5 (65.2–not reached) | 28.2 (22.3–33.8) | Anemia: 69%; neutropenia: 92%; thrombocytopenia: 38%; neuropathya: 7% | ||||
| Clamp et al., 2017 [18]; ICON‐8 | 1,566 | Prospective, randomized | 3W | 175 | 5/6 | 21 | 6 | 24.4 | All grade 3–4 toxicities: 42% | No benefit to any regimen | |
| W | 80 | 5/6 | 21 | 6 | 24.9 | All grade 3–4 toxicities: 42% | |||||
| W | 80 | 2 | 21 | 6 | 25.3 | All grade 3–4 toxicities: 42% | |||||
| Pignata et al., 2014 [16]; MITO‐7 | 810 | Prospective, randomized | 3W | 175 | 6 | 21 | 6 | 17.3 (15.2–20.2) | Neutropenia: 50%; thrombocytopenia: 7%; neuropathya grade 2–4): 17% | PC‐W improved quality of life and showed a better toxicity profile, but did not prolong PFS | |
| W | 60 | 2 | 21 | 6 | 18.3 (16.8–20.9) | Neutropenia: 42%; thrombocytopenia: 1%; neuropathya (Grade 2–4): 6% | |||||
| Abaid et al., 2013 [28] | 88 | Prospective | W | 80 | 5/6 | 28 | 6 | 31.5 | 22.5 | Neutropenia: 22.7 %; thrombocytopenia: 7.9 %; anemia: 1.1 % | Modified dose‐dense PC‐W preserves the efficacy of traditional dose‐dense chemotherapy, while minimizing hematologic toxicity |
| Ebata et al., 2016 [29] | 74 | Retrospective | W | 80 | 6 | 21 | 6 | 55.1 (44.6–not reached) | 19.0 (16.2–23.7) | Anemia: 41.9%; neutropenia: 55.4%; thrombocytopenia: 21.6%; neuropathya: 8.1% | Dose‐dense carboplatin + paclitaxel was effective and tolerable |
| Van der Burg et al., 2014 [30] | 267 | Prospective, randomized | 3W | 175 | 6 | 21 | 6 | 41.1 (34.4–47.7) | 16.4 (13.5–19.2) | Anemia: 3%; neutropenia: 38.2%; thrombocytopenia: 3%; neuropathya: none | There was no benefit in terms of OS, PFS, or RR for a weekly regimen nor for extended chemotherapy as first‐line treatment for EOC in European patients |
| W | 90 | 4 | 28 | 6 | 44.8 (33.1–56.5) | 18.5 (15.9–21) | Anemia: 13.5%; neutropenia: 61.2; thrombocytopenia: 11.4%; neuropathya: 1.5% |
Randomized studies are shown in bold.
aPeripheral sensory neuropathy.
Abbreviations: CI, confidence Interval; EOC, epithelial ovarian cancer; OS, overall survival; PC‐W, weekly paclitaxel and carboplatin regimen; PC‐3W, three‐weekly paclitaxel and carboplatin regimen; PFS, progression‐free survival; RR, response rate.
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