New Combinations and Dose Schedules

GOG 182/ICON-5 is a large multicenter randomized trial, which closed to accrual in 2005 (Fig. 8-10). The aim of this study was to determine whether adding a third drug (topotecan, liposomal doxorubicin, or gemcitabine) and adjusting schedules

Randomization Optimal and Suboptimal Stages III and IV

Control arm:

Carboplatin AUC 6 IV day 1

Paclitaxel 175 mg/m2 IV day 1

Control arm:

Carboplatin AUC 6 IV day 1

Paclitaxel 175 mg/m2 IV day 1

Gemcitabine triplet:

Carboplatin AUC 5 IV

day 1

Paclitaxel 175 mg/m2 IV

day 1

Gemcitabine 800 mg/m2 IV

day 1, 8

Doxil triplet: Carboplatin AUC 5 IV day 1

Paclitaxel 175 mg/m2 IV day 1 Doxil 30 mg/m2 IV every other day 1

Doxil triplet: Carboplatin AUC 5 IV day 1

Paclitaxel 175 mg/m2 IV day 1 Doxil 30 mg/m2 IV every other day 1

Topotecan doublet:

Carboplatin AUC 5 IV

day 1

Topotecan 1.25 mg/m2 IV

day 1-3 x 4 cycles

Followed by

Carboplatin AUC 6 IV

day 1

Paclitaxel 175 mg/m2 IV

day 1 x 4 cycles

Gemcitabine doublet:

Carboplatin AUC 6 IV

day 1

Gemcitabine 1000 mg/m2 IV

day 1

8 x 4 cycles

Followed by

Carboplatin AUC 6 IV

day 1

Paclitaxel 175 mg/m2 IV

day 1

x 4 cycles

Figure 8-10. Schema for GOG 182: triplet and sequential doublet chemotherapy.

Paclitaxel 135 mg/m2 IV over 24 hours-day 1 Cisplatin 75 mg/m2 IV-day 2 Cycles q 3 weeks x 6

Paclitaxel 135 mg/m2 IV over 24 hours-day 1 Cisplatin 100 mg/m2 IV-day 2 Paclitaxel 60 mg/m2 IP-day 8 Cycles q 3 weeks x 6

Figure 8-11. Schema for GOG 172 trial of intraperitoneal (IP) chemotherapy.

Figure 8-11. Schema for GOG 172 trial of intraperitoneal (IP) chemotherapy.

(i.e., using sequential doublets) could improve outcomes of patients with advanced epithelial ovarian cancer. Carboplatin and paclitaxel served as the control arm in this five-arm trial. These data are maturing and results are pending.65

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