The efficacy of PLD has been clearly documented in recurrent ovarian cancer giving the rationale for its use also in the first-line setting. The MITO-2 (Multicenter Italian Trials in Ovarian cancer) phase III was designed
to compare the combinations of carboplatin plus paclitaxel to an experimental arm with carboplatin plus PLD in first-line AZD5363 mw treatment of ovarian cancer patients. Results have been presented at ASCO 2010 showing that carboplatin plus PLD is not superior to carboplatin plus paclitaxel in terms of PFS; the median PFS was 19 and 16.8 months www.selleckchem.com/products/mi-503.html in the former and the latter arms, respectively. However, given the observed confidence interval and the different toxicity profile it has been proposed that carboplatin plus
PLD could be considered an alternative to standard therapy . Several randomized trials have been performed in platinum-sensitive patients. A multicenter phase III study, recently published, the Calypso study , has compared efficacy and safety of PLD-carboplatin and carboplatin-paclitaxel in 976 relapsed platinum-sensitive ovarian cancer patients. The trial showed superiority of the experimental arm in terms of PFS (11.3 months versus 9.4; HR = 0.821, Nutlin-3 mouse 95% CI 0.72-0.94; P = 0.005). The safety profile of PLD-carboplatin appears remarkably different from that of carboplatin plus paclitaxel. The PLD-carboplatin combination was associated with a higher incidence of anemia and thrombocytopenia (rarely requiring transfusions) and a higher incidence of stomatitis and cutaneous toxicity (that were rarely severe, 14% of G1-2). Notably,
however, the PLD-carboplatin combination was associated with a very low incidence of hair loss and neurotoxicity compared between the 2 arms was found in terms of response rate . One interesting observation of this trial was in PLD-carboplatin arm compared to carboplatin-paclitaxel there was the reduction in the rate of hypersensitive reaction (grade > 2: 5.6% versus 18.8%) Therapeutic MTMR9 Strategies in Epithelial Ovarian Cancer and this is important information since hypersensitive reactions are reported in the general practice in patients treated with carboplatin up to 25%. Treatment of clear cell type of EOC Although clear cell type is categorized in Type I (indolent) ovarian cancer, it is known to show relatively strong resistance to carboplatin and paclitaxel regimen and thus poor prognosis compared to serous adenocarcinoma (SAC), especially in advanced stages. Previously Sugiyama et al.