A randomised comparison of treosulfan and carboplatin in patients with ovarian cancer: A study by the Scottish Gynaecological Cancer Trials Group (SGCTG)

TitleA randomised comparison of treosulfan and carboplatin in patients with ovarian cancer: A study by the Scottish Gynaecological Cancer Trials Group (SGCTG)
Publication TypeJournal Article
Year of Publication2006
AuthorsReed, NSimon, Poole, CJ, Coleman, RL, Parkin, D, Graham, JD, Kaye, SB, Ostrowski, J, Duncan, I, Paul, J, Hay, A, Group, SGynaecolog
JournalEur J Cancer
Volume42
Pagination179-85
KeywordsAged Antineoplastic Agents/*therapeutic use Antineoplastic Agents, Alkylating/therapeutic use Busulfan/*analogs & derivatives/therapeutic use CA-125 Antigen/metabolism Carboplatin/*therapeutic use Female Humans Infusions, Intravenous Middle Aged Ovarian Neoplasms/*drug therapy Quality of Life Survival Analysis Treatment Outcome
Abstract

The management of older and unfit women with advanced ovarian cancer requires post-operative chemotherapy but many of these patients are not suitable for high-dose cisplatin-based regimes. Carboplatin has been an easier alternative and can be given in the ambulatory setting. Historical data suggests that oral alkylating agents to be just effective with similar efficacy. In this study we have compared platinum-based carboplatin to the alkylating agent treosulfan in a population unfit to receive high-dose cisplatin. The trial randomised patients to either intravenous carboplatin or treosulfan as single agent. The trial was stopped prematurely after the interim analysis showed improved survival and response rates in the carboplatin arm. We conclude that carboplatin is a safe and effective drug in a population that is unfit for high-dose cisplatin. Treosulfan showed limited activity but may be considered along with other oral drugs in limited circumstances. With the exception of myelosuppression, toxicity was mild in both arms. Carboplatin remains the gold standard in this older and less fit group of patients.