- Weekly dose-dense paclitaxel-based chemotherapy is feasible but fails to extend PFS in predominantly European patients with ovarian cancer vs chemotherapy administered every 3 weeks (3-weekly chemotherapy).
Why this matters
- The Japanese JGOG3016 trial showed a significant survival advantage with dose-dense weekly paclitaxel and 3-weekly carboplatin.
- Phase 3 ICON8 trial of 1566 women with newly diagnosed International Federation of Gynecology and Obstetrics stage IC-IV epithelial ovarian cancer.
- Patients were randomly assigned to 3-weekly carboplatin-paclitaxel (group 1), 3-weekly carboplatin and weekly dose-dense paclitaxel (group 2), or weekly carboplatin with weekly dose-dense paclitaxel (group 3).
- Funding: Cancer Research UK; Medical Research Council; others.
- Compared with 3-weekly carboplatin-paclitaxel, median total paclitaxel dose was higher in the weekly dose-dense groups (1010 vs 1233 and 1274 mg/m2).
- 65% of patients experienced disease progression.
- No significant difference in median PFS was observed in group 1 vs group 2 (17.7 vs 20.8 months; P=.35) and vs group 3 (vs 21.0 months; P=.51).
- Grade 3-4 adverse were higher in groups 2 and 3 vs 1 (62% and 53% vs 42%).
- Uncomplicated neutropenia was a major contributor for higher grade 3-4 toxicities (35% and 30% vs 15%).
- Incidences of febrile neutropenia and sensory neuropathy were similar across groups.
- Open-label design.