Quadrichemotherapy for advanced ovarian carcinoma.

In an effort to improve the length and rate of objective responses in patients with advanced ovarian carcinoma, a combination of four drugs was administered. Vincristine (10 mug/kg intravenously weekly), actinomycin D (500 mug intravenously weekly), oral methotrexate (1.25 mg daily), and oral cyclophosphamide (50 mg daily) were given to 25 evaluable patients with FIGO Stage III and IV ovarian carcinoma. After 12 weeks the vincristine and methotrexate were discontinued; cyclophosphamide and methotrexate were continued until disease progression was evident. Objective responses occurred in 56% of the patients. Toxicity was minimal. Patients not previously treated with radiotherapy or chemotherapy had a higher complete response rate (30%) than patients previously treated (13.3%). Mean length of complete response was 10.6+ months. The 1-year survival rate of these patients was 69.5% and the 5-year rate 22.7%. While the results are encouraging, single agent chemotherapy with an alkylating agent produces similar responses.