Treating women with relapsed platinum-sensitive ovarian cancer with combined carboplatin and pegylated liposomal doxorubicin prolongs progression free survival and is associated with a lower risk of severe, long lasting nerve damage than standard carboplatin/paclitaxel treatment.

This was the key conclusion from the international multicentre CALYPSO trial reported this week at the 16th International Meeting of the European Society of Gynaecological Oncology (ESGO) in Belgrade, Serbia, by Dr Mark Heywood, from the BCCA Vancouver Cancer Centre, Vancouver, Cancer.

Data from 986 patients treated in 16 countries in Europe, North America, the Middle East, Australia and New Zealand showed progression free survival of 11.3 months and 9.4 months respectively (p=0.005) for the carboplatin/pegylated doxorubicin vs carboplatin/paclitaxel combinations in women with relapsed platinum sensitive disease (ovarian cancer that had relapsed more than six months after treatment with platinum-based chemotherapy).

Severe neutropenia occurred in 35% and 46% respectively of patients in the two groups, severe neuropathy in 5% and 28% and alopecia in 7% and 84%. Hand-foot syndrome – a well documented inflammatory condition associated with pegylated doxorubicin was more common in the carboplatin/pegylated doxorubicin group (13% vs 2%) and severe thrombocytopenia was also more common (16% vs 6%). Treatment needed to be discontinued early in 4.3% of patients in the carboplatin/pegylated doxorubicin group, compared to 14% of those on the standard regime.

Dr Heywood pointed out that an unexpected advantage of adding doxorubicin to carboplatin was the reduction in sensitivity reactions to carboplatin seen in the novel treatment group compared to that normally seen with carboplatin alone or in other combinations.

He concluded that the carboplatin/pegylated doxorubicin combination provided a superior risk benefit ratio compared with carboplatin/paclitaxel for women with relapsed, platinum sensitive ovarian cancer.