Phase III trial of gemcitabine compared with pegylated liposomal doxorubicin in progressive or recurrent ovarian cancer
- PMID: 18281662
- DOI: 10.1200/JCO.2007.13.6606
Phase III trial of gemcitabine compared with pegylated liposomal doxorubicin in progressive or recurrent ovarian cancer
Abstract
Purpose: We aimed at investigating the efficacy, tolerability, and quality of life (QOL) of gemcitabine (GEM) compared with pegylated liposomal doxorubicin (PLD) in the salvage treatment of recurrent ovarian cancer.
Patients and methods: A phase III randomized multicenter trial was planned to compare GEM (1,000 mg/m(2) on days 1, 8, and 15 every 28 days) with PLD (40 mg/m(2) every 28 days) in ovarian cancer patients who experienced treatment failure with only one platinum/paclitaxel regimen and who experienced recurrence or progression within 12 months after completion of primary treatment.
Results: One hundred fifty-three patients were randomly assigned to PLD (n = 76) or GEM (n = 77). Treatment arms were well balanced for clinicopathologic characteristics. Grade 3 or 4 neutropenia was more frequent in GEM-treated patients versus PLD-treated patients (P = .007). Grade 3 or 4 palmar-plantar erythrodysesthesia was documented in a higher proportion of PLD patients (6%) versus GEM patients (0%; P = .061). The overall response rate was 16% in the PLD arm compared with 29% in the GEM arm (P = .056). No statistically significant difference in time to progression (TTP) curves according to treatment allocation was documented (P = .411). However, a trend for more favorable overall survival was documented in the PLD arm compared with the GEM arm, although the P value was of borderline statistical significance (P = .048). Statistically significantly higher global QOL scores were found in PLD-treated patients at the first and second postbaseline QOL assessments.
Conclusion: GEM does not provide an advantage compared with PLD in terms of TTP in ovarian cancer patients who experience recurrence within 12 months after primary treatment but should be considered in the spectrum of drugs to be possibly used in the salvage setting.
Comment in
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Is single-agent chemotherapy acceptable in platinum-sensitive relapsed ovarian cancer?J Clin Oncol. 2008 May 20;26(15):2602-3; author reply 2603. doi: 10.1200/JCO.2008.16.9243. J Clin Oncol. 2008. PMID: 18487582 No abstract available.
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Serious ethical dilemma of single-agent pegylated liposomal Doxorubicin employed as a control arm in ovarian cancer chemotherapy trials.J Clin Oncol. 2010 Jul 1;28(19):e319-20; author reply e321-2. doi: 10.1200/JCO.2010.28.9934. Epub 2010 Jun 1. J Clin Oncol. 2010. PMID: 20516447 No abstract available.
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