Cisplatin-based combination chemotherapy consisting of ifomide, epirubicin, and cisplatin (IEP) is effective for patients with relapsed ovarian carcinoma (ROC) resistant or refractory to TC (paclitaxel/carboplatin).

16507 Background: To evaluate the efficacy and toxicity of IEP for patients (pts) with relapsed EOC.,Eligible pts had histologically-confirmed serous, endometrioid, or transitional cell carcinoma of the ovary measuring more than 2 cm in diameter, age ≤ 75 yrs, WHO PS ≤ 3, adequate pulmonary, cardiac, hematopoietic, liver and renal functions, and written informed consent. The IEP regimen was as follows: ifomide, 700 mg/m infused over 2 hrs, days 1-7; epirubicin, 50 mg/m as a bolus, day 5; and cisplatin 15 mg/m infused over 2 hrs, days 1-5. The treatment was repeated at 4-week intervals.,Forty eligible pts were enrolled in this study. The median age was 51 yrs (range, 41-64). All pts received more than 6 cycles of TC. Thirty- four of 40 pts (85%) had 1 or more previous chemotherapy other than TC. Histologic types were serous (33 pts), endometrioid (5 pts), and transitional (2 pts). After a median of 4 cycles (range, 2-10), we observed objective responses in 28 pts (70%), with 4 (10%) CRs and 24 (60%) PRs, and 12 (30%) NCs. Median overall survival time (MOS) for all 40 pts was 24.3 months (mo) (range, 4 to 78). MOS of pts achieving CR, PR, and NC were 'not reached", 23.6 mo, 8.2 mo, respectively (Log-rank, p < 0.001). The most frequent Grade 3-4 hematologic toxicities were; neutropenia 57.8%, anemia 43.3%, and thrombocytopenia 14.4%. Alopecia (Grade 1-2) occurred in 91.3%, but there was no grade 2 or 3 peripheral neuropathy, nephrotoxicity, or cardiotoxicity.,IEP regimen has significant anti-tumor activity with acceptable toxicity and appreciable response duration. Several studies have demonstrated that cisplatin is more effective than carboplatin in almost all platinum-sensitive disease except OC (Lokich J: Cancer Invest 19: 756, 2001). In OC, carboplatin was demonstrated equal to cisplatin in anti-tumor response in optimal disease (GOG 158, AGO), but the equivalency was not demonstrated in suboptimal disease. We must reappraise cisplatin is an agent that should be included in the first line for platinum-sensitive OC. No significant financial relationships to disclose.