Advanced ovarian cancer. Carboplatin versus cisplatin.

BACKGROUND

Since the introduction of the second generation platinum compound carboplatin, debate has taken place about whether this analogue can replace cisplatin in combination chemotherapy regimens for the treatment of ovarian cancer patients.

MATERIALS AND METHODS

In the present review the pharmacologic characteristics of carboplatin and cisplatin and the results of comparative studies are described.

RESULTS

Many of the trials performed comparing carboplatin with cisplatin, either as single agent first-line therapy or in combination chemotherapy suggest equivalent results. However, most of these trials are characterized by an inadequate patient number to detect small but important differences, inadequate carboplatin doses, ratios < 4:1, and crossover to the other analogue which makes survival comparisons difficult. Superior results in terms of either progression-free survival or overall survival have been obtained with cisplatin in two larger randomized studies of combination chemotherapy. Furthermore, another randomized study indicates substantial differences in favour of cisplatin in the subgroup of patients with < 1 cm residual tumour. Generally, there is a lack of long-term follow up.

CONCLUSIONS

Based on the presently available data it is recommended that carboplatin should not routinely replace cisplatin in the management of patients with potentially curable small volume disease.