[Docetaxel and ovarian cancer]

Docetaxel has exhibited substantial clinical activity against platinum, refrac- tory, paclitaxel resistant and previously untreated advanced ovarian cancer. As single agent, in advanced ovarian cancer patients previously treated with platinum agents, docetaxel 100 mg/m(2) every 3 weeks yields a 30% overall response rate and 6 months duration of response. In vitro data demonstrate a lack of complete cross-resistance bet- ween docetaxel and paclitaxel. In both platinum- and paclitaxel-pretreated patients, the highest response rates were obtained in patients with the longest interval of time since receipt of prior chemotherapy. Docetaxel currently is being intensively evaluated as a component of first line combination chemotherapy for ovarian cancer. Phase I-II have shown that docetaxel-platinum doublets are feasible and highly effective in the treatment of ovarian cancer, with docetaxel-carboplatin providing a more favorable safety profile compared with docetaxel-cisplatin, particularly with respect to neurotoxicity. The preliminary results of a phase III comparison of docetaxel-carboplatin versus paclitaxel-carboplatin support the clinical use of docetaxel-carboplatin as first line chemotherapy for stage IC to IV ovarian cancer, as it was shown to reduce the incidence of grade > 2 neurosensory toxicity compared to paclitaxel-carboplatin. Comparative overall survival and quality of life and more mature progression free survival data will be instrumental in determining the relative merits of docetaxel-carboplatin and paclitaxel-carboplatin as first line adjuvant therapy for ovarian cancer. The positive clinical experiences with docetaxel-provide a strong basis for continued investigation of docetaxel-carboplatin-based chemotherapy as component of advanced ovarian cancer management.