PAC-HF                                               ovarian(120)
 _________________________________________________________________
  adriamycin...... 70 mg/sqm IV on days(weeks) 1(0), 22(3), 43(6), 
                   211(30), 232(33), and 253(36).
  cisplatin....... 100 mg/sqm IV in 6 l normal saline over 24 h on 
                   same days as adriamycin above.
  cytoxan......... 100 mg/sqm/day orally for 14 days beginning on 
                   days(weeks) 64(9), 92(13), 120(17), 148(21), 
                   176(25), and 204(29).
  hexamethylmelami 150 mg/sqm/day orally for 14 days on same days 
                   as cytoxan above.
  fluorouracil.... 600 mg/sqm IV on the same days specified for 
                   cytoxan above.
  FREQUENCY....... Specified above.

  reference...
    Griffin TW.  Hunter RA.  Cederbaum AI.  Tak WK.  Ward AD. 
    Schwartz JH.  Halpin TF.  Strauss GM.  Meyer RN.  Liepman MK.  
    et al. Treatment of advanced ovarian cancer with sequential 
    combination chemotherapy. Cancer.  60(9):2150-5, 1987 Nov 1. 
  abstract...
    Fifty previously untreated patients with advanced or recurrent 
    ovarian cancer (FIGO Stages III and IV) were treated with 
    alternating combination chemotherapy. This consisted of 
    high-dose doxorubicin (70 mg/m2) and cisplatin (100 mg/m2) 
    alternated with CHF (cyclophosphamide, hexamethylmelamine, and 
    5-fluorouracil). Toxicity (myelosuppression, nephropathy, and 
    neuropathy) was infrequent and mild. Clinical response rates 
    were high (94% response, 62% complete clinical response), but 
    the majority of patients had residual intraabdominal disease 
    at second-look surgery (75%). Thirteen patients (26%) are 
    alive after 4 years of observation (minimum follow-up). 
    Survival was adversely influenced in patients who were older 
    than 70, had Stage IV disease, residual tumor bulk greater 
    than 2 cm, and who failed to achieve complete clinical 
    remission. The median duration of survival (28 months) and 
    percentage of long-term survivors appear similar to that in 
    other platinum-based chemotherapy studies. Although the role 
    of alternating combination chemotherapy in epithelial ovarian 
    cancer remains undefined, it is likely that an alternate 
    approach will be necessary to markedly improve survival rates 
    for patients with this disease.