“Major progress” has been achieved in developing chemotherapy combinations to prolong life in patients with ovarian cancer, according to a team of researchers in Greece, the UK, and the US. The top contender appears to be a combination of two types of cancer drugs - platinums and taxanes - administered intraperitoneally (directly into the abdominal cavity).

“Distinct incremental changes” have occurred in the treatment of ovarian cancer over the last four decades, Dr. John P. A. Ioannidis, of the University of Ioannina School of Medicine in Greece, and his colleagues note. Still, the exact extent of survival benefit has yet to be quantified, which must be known to weigh the pros and cons of treatment.

Therefore, Ioannidis and his associates conducted a search of published studies of ovarian cancer that enrolled five or more patients. Altogether, 60 trials published between 1971 and 2006 compared different chemotherapy combinations and reported survival data for 15,609 patients.

During the 1970s, the available ovarian cancer drugs were cisplatin, paclitaxel, cyclophosphamide, doxorubicin, carboplatin and paclitaxel, the investigators note.

Platinum-based combinations prevailed in the 1980s and 1990s.

And since the beginning of the millennium, platinum and taxanes have been the most successful treatment, which provides even better survival when administered intraperitoneally.

Before platinum and taxanes were available, chemotherapy was no better than supportive care, the authors note.

Ioannidis and his team found that a combination of platinum and taxane administered intraperitoneally “can reduce the risk of death by 55 percent.” Without effective treatment, the average survival is 2.5 years, but about 3 years are gained when the most effective combination is used.

If major progress is to made in treating ovarian cancer, the investigators note, researchers need to cooperate to develop complementary trials, decrease duplication and conduct trials together when appropriate. They say this is especially important as new drug combinations come along.

SOURCE: Journal of the National Cancer Institute, November 15, 2006.