Improved survival with single-agent paclitaxel consolidation/maintenance therapy in advanced ovarian carcinoma.

Overview

OBJECTIVES: Consolidation/maintenance therapy in the standard management of ovarian cancer remains controversial, primarily due to the unknown impact of this strategy on overall survival. METHODS: We examined the survival of a previously reported patient population consecutively treated with either 3 cycles (group A; n = 13 patients) or 12 cycles (group B; n = 13) of single-agent paclitaxel consolidation following 6 cycles of primary induction chemotherapy comprising 6 cycles of carboplatin (AUC = 5), paclitaxel (175 mg/m(2)) and gemcitabine (800 mg/m(2)). RESULTS: There were no differences in the 2 patient populations regarding known relevant prognostic factors (age, stage, tumor grade). The median progression-free survival was 11 months for group A and 24 months for group B (p = 0.0062). The median overall survival in group A was 38 months and was not reached in group B (p = 0.0019). Current follow-up for these 2 patient groups exceeds 43 months. CONCLUSION: We recognize the important limitations of this study, particularly its sample size and nonrandomized nature. However, these data provide support for the conclusion that paclitaxel 'maintenance/consolidation' therapy may favorably impact overall and progression-free survival in advanced ovarian cancer patients who achieve an excellent response to primary platinum-based chemotherapy.