Weekly dose-dense chemotherapy does not improve progression-free survival (PFS) compared with standard three-weekly chemotherapy, reports research published in the Lancet.
The phase 3 randomised controlled ICON8 trial compared the efficacy and safety of two dose-dense weekly regimens to standard three-weekly chemotherapy in women with newly diagnosed International Federation of Gynecology and Obstetrics stage IC-IV epithelial ovarian cancer. Patients entered the trial after immediate primary surgery or before neoadjuvant chemotherapy with subsequent planned delayed primary surgery.
A total of 1,566 participants (predominantly European) were randomised to receive carboplatin area under the curve (AUC)5 or AUC6 and 175 mg/m2 paclitaxel every three weeks (group 1), carboplatin AUC5 or AUC6 every three weeks and 80 mg/m2 paclitaxel weekly (group 2) and carboplatin AUC2 and 80 mg/m2 paclitaxel weekly (group 3).
Median PFS was 17.7 months (IQR 10.6-not reached) in group 1, 20.8 months (IQR 11.9-59.0) in group 2 and 21.0 months (95% CI 12.0-54.0) in group 3 (P=.35 for group 2 vs group 1; P=.51 for group 3 vs 1).
The authors concluded that although weekly dose-dense chemotherapy can be delivered successfully as first-line treatment for epithelial ovarian cancer, it does not significantly improve PFS compared with standard three-weekly chemotherapy in predominantly European populations.