Second-line therapy with paclitaxel and carboplatin for recurrent disease following first-line therapy with paclitaxel and platinum in ovarian or peritoneal carcinoma

Purpose: The combination of paclitaxel and a platinum compound is the most active first-line regimen for advanced ovarian carcinoma. The current study was undertaken to evaluate this combination in the retreatment of patients with ovarian or peritoneal carcinoma who had disease recurrence greater than or equal to 6 months following this combination. Methods: Twenty-five patients with recurrent ovarian or peritoneal carcinoma greater than or equal to 6 months after a complete clinical response with first-line paclitaxel and platinum chemotherapy were studied, Recurrent disease was documented by computed tomography (CT), elevated CA 125 level, or surgical findings, Second-line chemotherapy consisted of paclitaxel 135 mg/m(2) as a 24 hour infusion and carboplatin at an area under the concentration-time curve (AUG) of 5 to 6 every 21 days, Response to therapy was classified as measurable or assessable. Results: The median time to recurrence after first-line therapy was 10 months (range, 6 to 30). Among 20 measurable and assessable patients, 14 (70%) demonstrated a complete clinical response and four (20%) a partial clinical response, The response rate with measurable disease was 91% and with assessable disease was 89%, The median progression-free interval for all patients was 9.0+ months (range, 2 to 15), The median progression-free interval for patients with measurable or assessable disease was 9.0+ months and for nonassessable disease was 7.0+ months. Fifteen patients (60%) have developed recurrence after secondary therapy at a median interval of 9.0 months (range, 2 to 15), Only two patients have died with a median survival after secondary therapy of 10.0+ months (range, 2.0 to 21.0+), Conclusion: The use of this combination, in this sensitive population, has a high response rate and long progression-free interval. In a chemotherapy-sensitive population, the activity of alternative second-line agents must be interpreted with this perspective. (C) 1998 by American Society of Clinical Oncology.