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GOG 172

Intraperitoneal cisplatin and paclitaxel in ovarian cancer

Pubmed

First Author: Armstrong DK

Hypothesis: IP chemotherapy improves overall survival in optimally debulked ovarian cancer

Site: Ovary

Experimental arm: 135 mg/m2 paclitaxel (IV-24hrs) cisplatin 100 mg/m2 IP day 2 60 mg Paclitaxel IP day 8 (All IP meds with 2 L warm saline)

Standard Arm: 135 mg/m2 Paclitaxel (IV-24hrs) cisplatin 75mg/m2 IV on day 2

Primary Outcome: Overall survival

Results:

Outcome IP/IV IV only p-value
PFS 23.8 18 SS
OS 65.6 49.7 SS
Completed all planned cycles 42% 83% SS
G3/G4Toxicity
GI 46% 24% SS
Neutropenia 76% 64% SS
Neuropathy 19% 9% SS
Fatigue 18% 4% SS

Conclusions: Significant improvement in PFS and OS in optimally debulked patients (<1 cm)

Controversies (Select editorials worth reading)

Pro IP chemotherapy

Against IP chemotherapy


GOG 240

Improved Survival with Bevacizumab in Advanced Cervical Cancer

Pubmed             Free PMC article

Hypothesis: Addition of Bevacizumab improves overall survival

Site: Cervix

Experimental arm: Cisplatin (50mg/mg/m2) plus paclitaxel (135 or 175 mg/m2)
OR Topotecan (0.75 mg/m2 days 1,2,3) plus paclitaxel (175 mg/m2)

Standard Arm:Cisplatin (50mg/mg/m2) plus paclitaxel (135 or 175 mg/m2) Bevacizumab
OR Topotecan (0.75 mg/m2 days 1,2,3) plus paclitaxel (175 mg/m2) Bevacizumab

Primary Outcome: Overall Survival

Results:

Outcome Cis/Taxol OR Cis/Topo Cis/Taxol/Bev Or Cis/Topo/Bev p-value
Overall Survival (mths) 13.3 17 SS
Fatal adverse event % 1.8 1.8 NS
G3 fistula % 1 6 SS
G2 or higher HTN 2 25 SS
Febrile neutropenia % 5 5 NS
Thromboembolism % 1 8 SS

Conclusions: Adding Bevacizumab significantly improves OS in cervical cancer