ESMO 2017: 3-week dosing schedule for paclitaxel is suitable as first-line treatment for European women with ovarian cancer

  • Oncology Conference Roundups
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  • Caucasian women with ovarian cancer can be treated with the standard 3-week dosing schedule for paclitaxel according to ICON8 phase 3 study presented at ESMO 2017.

Why this matters

  • The study, conducted by the MRC Clinical Trials Unit at UCL, contradicts the results of the JGOG3016 Japanese study that reported a significant increase in median progression-free survival and overall survival in those treated with dose-dense weekly paclitaxel.
  • The differences in patients’ response within the European and Japanese trial could be linked to differences in pharmacogenomics.

Study design

  • 1566 predominantly European patients with ovarian cancer were randomly assigned to receive 6 cycles of either the standard 3-week dosing regimen of carboplatin and paclitaxel (Arm 1), compared with once-weekly dose-dense paclitaxel (carboplatin AUC 5/6+paclitaxel 80 mg/mq weekly, Arm 2; and carboplatin AUC 2+paclitaxel 80 mg/mq weekly, Arm 3).
  • Funding: Cancer Research UK. 

Key results

  • The study found no benefit from once-weekly regimens.
  • Progression-free survival was 24.4 months in Arm 1, 24.9 months in Arm 2, and 25.3 months in Arm 3.
  • Restricted mean survival time was 24.4, 24.9, and 25.3 months in Arms 1, 2, and 3, respectively.
  • There was a slight increase in grade 3-4 toxicity in Arms 2 and 3 compared with Arm 1 (63% versus 53% versus 42%, respectively).

Expert comment 

  • Dr. Domenica Lorusso, from Fondazione IRCCS National Cancer Institute of Milan, Chair of the Gynaecological Tumours track at ESMO 2017, said: “The trial confirms that carboplatin-paclitaxel every 3 weeks is the standard first-line treatment for ovarian cancer, a standard which has remained unmodified in the last 20 years, at least in the Caucasian population.”