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
FREQUENCY....... Specified above.
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.
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.