[MOL] Ovarian cancer results cause a stir at cancer conference...... [01207] Medicine On Line

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[MOL] Ovarian cancer results cause a stir at cancer conference......

|    Ovarian-cancer results cause a stir at cancer conference
| Lancet 2000; 355: 1893 - 1896 Download PDF (96 Kb)
| The negative results of a UK-based trial caused a stir at the 36th annual
meeting of the American Society of Clinical Oncology
| (ASCO; New Orleans, Louisiana, USA, May 20-23). Nicoletta Colombo
presented data from ICON-3, the Third International Collaborative
| Ovarian Neoplasm Study. In this trial, the taxane paclitaxel combined with
carboplatin was compared as the test arm against either
| of two control arms: carboplatin alone or cyclophosphamide plus
doxorubicin plus cisplatin (CAF). 2074 newly diagnosed patients
| entered the trial. Colombo said that the median follow-up was 29 months
and that there had been 1293 events (including 1155
| progressions of disease and 925 deaths).
| Colombo went on to report no difference in progression-free or overall
survival between the test and control arms. The hazard ratio
| for progression-free survival was 096 in favour of the taxane plus
carboplatin arm, which gave an estimated absolute difference at
| 1 year of 1% (50% versus 51%). The hazard ratio for overall survival was
093, with an estimated absolute difference at 2 years of
| 2% (62% versus 64%).
| These results from ICON-3 are different from previous trials of the taxane
combined with a platinum compound, and Robert C Young
| (Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA), who was the
discussant after the ICON-3 presentation, pointed out that
| the initial selection of the control treatment, which was left to the
individual doctor before randomisation, was "maldistributed":
| 1421 patients received carboplatin alone and 653 received CAF. In
addition, paclitaxel plus carboplatin was more effective in
| patients with bulky disease than in those with minimal or no residual
disease, a difference not seen in earlier trials. 130
| institutions in four countries participated in ICON-3, with an average of
16 patients per centre, and Young also pointed out that
| outcome was better in the control arms in centres with low participation.
| Colombo replied that the mature results of the earlier ICON-2 study showed
that the two control regimens in ICON-3 were equally
| effective, thus negating any imbalance in selection of the control. She
was insistent that Young's analysis of the bulky-disease
| data was based on year-old findings, and that the updated analysis she had
presented this year showed no such effect. She had also
| said in her presentation that the reason for some centres seemingly
recruiting low numbers of patients was because these centres had
| joined in ICON-3 at a late stage.
| David McNamee

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