Paclitaxel ± ifosfamide in advanced ovarian cancer (A.O.C.). Preliminary results of a multicentric pilot study

Paclitaxel activity with or without ifosfamide was investigated as salvage therapy in patients (pts) with a.o.c. Group I (n = 20 evaluable) pts received taxol alone 175 mg/m 2 , over 3 hours, every 3 weeks. Group II (n = 13 evaluable pts) received taxol 135 mg/m 2 as in Group I; escalating doses of ifosfamide (1; 1.5; 2 gr/m 2 ) was administered on days 2–3 with mesna rescue. In absence of severe toxicity, ifosfamide was administered at 2 gr/m 2 for the last three cycles. The average number of courses was respectively 4 in Group I (range 1–8) and 3 in Group II (range 1–6). Overall, 3 PR were observed in 15 pts with primary platinum resistant disease, 2 PR were observed in 8 pts with platinum sensitive disease while no response was observed in 10 pts with secondary platinum resistant ovarian cancer. Our results, although preliminary, suggest that taxol ± ifosfamide show a moderate but definite activity in so heavily pretreated category of pts. As expected the activity in platinum sensitive pts was twofold the activity achieved in platinum resistant pts, showing respectively 25% of PR vs 12% of PR. However, was to note that a 20% of activity was observed in primary platinum resistant pts. Moreover taxol plus ifosfamide association seems not to achieve better results than taxol alone, while it showed a higher haematologic toxicity. It is concluded that the number of previous therapeutic lines rather than the intrinsic sensitivity to cisplatin front line treatment is probably the major determinant of taxol activity when employed as salvage treatment.