Improved therapeutic index of carboplatin plus cyclophosphamide versus cisplatin plus cyclophosphamide: Final report by the Southwest Oncology Group of a phase III randomized trial in Stages III and IV ovarian cancer

David S Alberts, Stephanie Green, Edward V. Hannigan, Robert O'Toole, Donna Stock-Novack, Patricia Anderson, Earl A. Surwit, Vinay K. Malvlya, William A. Nahhas, Christopher J. Jolies

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272 Scopus citations


Purpose: To compare cisplatin-cyclophosphamide versus carboplatin-cyclophosphamide as primary chemotherapy for stage III (suboptimal) and stage IV ovarian cancer. Patients and Methods: Three hundred forty-two patients were randomly assigned to treatment with six courses of intravenous (IV) cisplatin 100 mg/m2 plus IV cyclophosphamide 600 mg/m2, or IV carboplatin 300 mg/m2 plus IVcyclophosphamide 600 mg/m2. Results: The estimated median survivals were 17.4 and 20.0 months for the cisplatin and carboplatin study arms, respectively. The null hypothesis of a 30% survival superiority with the cisplatin arm was refected at the P = .02 level. Clinical response rates were 52% for the cispla-tin arm and 61% for the carboplatin arm. Pathologic complete response rates were similar for both study arms. There was less thrombocytopenia on the cisplatin arm (P < .001); however, there was less nausea and emesis (P < .001 for courses 1 to 5), renal toxicity (P < .001), anemia (P = .01), hearing loss (P < .001), tinnitus (P = .01 ), neuromuscular toxicfties (P = .001), and alopecia (P < .001) on the carboplatin arm. Conclusion: Carboplatin-cyclophosphamide proved to have a significantly better therapeutic index than cisplafin-cyclophosphamide in patients with stage III (suboptimal) and stage IV ovarian cancer.

Original languageEnglish (US)
Pages (from-to)706-717
Number of pages12
JournalJournal of Clinical Oncology
Issue number5
Publication statusPublished - 1992
Externally publishedYes


ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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