Role of anthracyclines in first line combination chemotherapy of ovarian carcinoma.

The association of cisplatin plus cyclophosphamide (PC) is considered to be the standard medical treatment for advanced ovarian carcinoma, while the role of doxorubicin in combination with cisplatin and cyclophosphamide (PAC regimen) is still controversial. Recently, four randomized clinical trials evaluating PC versus PAC regimen have been published. None of these studies showed a convincing advantage for the addition of doxorubicin to PC. By pooling the data from the 1200 or so patients included in these four studies and analyzing them with the statistical technique of meta-analysis, a statistical benefit for PAC over PC is demonstrated in terms of pathologic complete response rate (30 vs 23%, P = 0.01) and 6-year survival rate (27 vs 21%, P = 0.01).