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| *Women health>>>Ovarian Cancer |
Carboplatin only for ovarian cancer? |
My mom's dr gave her taxol and carboplatin for her first treatment, but for the second he just did carboplatin saying that many european studies say the results are the same if carboplatin is used alone and not with taxol. Just wondering if anyone has heard this or if this is the right course to go. Not too many options though as my mom is without insurance and can't get any financial assistance. I have copied the following text from the NCI website. This info applies the Stage 3 and 4 ovarian cancer. This is essentially the "bible" when it comes to treating cancer. Carbo has been given alone as first line therapy and showed essentially the same overall and progression free survival as carbo/Taxol with less side effects. Systemic chemotherapy Since cisplatin was approved in 1979, first-line treatment of ovarian cancer has consisted of this drug being given intravenously or its second-generation analog, carboplatin, being given either alone or in combination with other drugs. Clinical response rates from these drugs regularly exceed 60%, and median time-to-recurrence usually exceeds 1 year in this subset of suboptimally debulked women. Trials by various cooperative groups in the subsequent two decades addressed issues of optimal dose-intensity [15-17] for both cisplatin and carboplatin,[18] schedule, [19] and the equivalent results obtained with either of these platinum drugs, usually in combination with cyclophosphamide.[20] With the introduction of the taxane paclitaxel in the early 1990s, two trials confirmed the superiority of cisplatin combined with paclitaxel to the previous standard of cisplatin plus cyclophosphamide; however, two trials that compared the agent with either cisplatin or carboplatin as a single agent failed to confirm such superiority in all outcome parameters (i.e., response, time-to-progression, and survival) Nevertheless, for patients with ovarian cancer, the combination of cisplatin or carboplatin and paclitaxel has been used as the initial treatment (defined as induction chemotherapy) for a number of reasons: GOG-132 was regarded by many as showing that sequential treatment of cisplatin and paclitaxel was equivalent to the combination because many patients crossed over before progression; moreover, the cisplatin only arm was more toxic because it utilized a 100 mg/m2 dose.[21] The Medical Research Council (MRC)-ICON3 study, while having fewer early crossovers, could be interpreted similarly in regard to the impact on survival of sequential treatment.[22] Data from MRC-ICON4 have shown a survival advantage for patients treated with the combination treatment regimen versus those treated with single-agent carboplatin upon recurrence (see Table 2). In past trials, single-agent platinums were not superior to platinum combined with an alkylating agent; therefore, the explanation of a detrimental effect of cyclophosphamide is unlikely. Since the adoption of the platinum-plus-taxane combination as the standard nearly worldwide, clinical trials have demonstrated: noninferiority for carboplatin plus paclitaxel versus cisplatin plus paclitaxel,[23-25] noninferiority for carboplatin plus paclitaxel versus carboplatin plus docetaxel,[26] and no advantage, but increased toxic effects, by adding epirubicin to the carboplatin plus paclitaxel doublet.[27] A study started by the GOG with international collaboration, currently published in abstract form, compared the carboplatin-plus-paclitaxel standard to two carboplatin-containing sequential doublets (one with topotecan and one with gemcitabine) followed by carboplatin plus paclitaxel, and to two triplets including either pegylated liposomal doxorubicin or gemcitabine with the standard doublet. No differences have emerged.[28] http://www.cancer.gov/cancertopics/pdq/t... Source(s): health care provider Ask for the study he's citing. Look and see if your mother fits in the study. There is too much information to say what the best treatment is without looking at all the specifics. Can your mother afford a second opinion at another medical center? Take the citations with you. |
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