1. Intraperitoneal Carboplatin for Ovarian Cancer - A Phase 2/3 Trial.
- Author
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Nagao, Shoji, Fujiwara, Keiichi, Yamamoto, Kouji, Tanabe, Hiroshi, Okamoto, Aikou, Takehara, Kazuhiro, Saito, Motoaki, Fujiwara, Hiroyuki, Tan, David S. P., Yamaguchi, Satoshi, Adachi, Sosuke, Kikuchi, Akira, Hirasawa, Takeshi, Yokoi, Takeshi, Nagai, Tomonori, Sato, Toyomi, Kamiura, Shoji, Fujishita, Akira, Loong, Wong Wai, and Chan, Karen
- Subjects
OVARIAN tumors ,CARBOPLATIN ,INTRAVENOUS therapy ,CONFIDENCE intervals ,INTRAPERITONEAL injections ,DISEASE incidence ,RANDOMIZED controlled trials ,TREATMENT effectiveness ,DESCRIPTIVE statistics ,STATISTICAL sampling ,PACLITAXEL ,PROGRESSION-free survival ,DRUG side effects ,OVERALL survival ,PHARMACODYNAMICS - Abstract
Background: Intraperitoneal chemotherapy has been shown to be effective at reducing mortality for patients with advanced epithelial ovarian cancer but is not widely used in practice. Methods: We performed the Intraperitoneal Therapy for Ovarian Cancer with Carboplatin (iPocc) trial as an open-label, international, multi-institutional, randomized phase 2/3 clinical trial in women with newly diagnosed epithelial ovarian cancer who underwent laparotomy or laparoscopy. All patients received intravenous paclitaxel (80 mg/m² on days 1, 8, and 15 of a 21-day cycle). In addition, patients in the control group received intravenous carboplatin (dose-dense intravenous paclitaxel plus intravenous carboplatin [dd-TCiv]), whereas patients in the experimental group received dose-dense intravenous paclitaxel plus intraperitoneal carboplatin (dd-TCip). The primary end point was progression-free survival (PFS). Secondary end points included overall survival, tumor response, treatment completion rate, and incidence of adverse events (AEs). Results: Among 655 patients randomized to treatment, median (95% confidence interval [CI]) PFS was 20.7 (18.1 to 22.8) months for dd-TCiv (n=328) and 23.5 (20.5 to 26.9) months for dd-TCip (n=327; hazard ratio, 0.83; 95% CI, 0.69 to 0.99; P=0.04). The PFS benefit with dd-TCip was consistent in patients with different baseline characteristics, stage, size of residual tumor, age, and performance status. The treatment completion rates were 68.3 and 59.9% in the dd-TCiv and dd-TCip groups, respectively. The incidence of intraperitoneal catheter-related AEs in the dd-TCip group was 10.1%; there were no such AEs in the dd-TCiv group. Conclusions: In the first-line treatment of advanced epithelial ovarian cancer, intraperitoneal carboplatin resulted in a modest prolongation of PFS when given with dose-dense weekly paclitaxel regardless of residual tumor size, with no impact on noncatheter-related toxicities. (Funded by the Japan Agency for Medical Research and Development, and others; Japan Registry of Clinical Trials number, jRCTs031180141.) [ABSTRACT FROM AUTHOR]
- Published
- 2023
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