A prospective randomized clinical trial of melphalan and cis-platinum versus hexamethylmelamine, adriamycin, and cyclophosphamide in advanced ovarian cancer

Creighton L. Edwards, Jay Herson, David M. Gershenson, Larry J. Copeland, J. Taylor Wharton

Research output: Contribution to journalArticle

Abstract

From May 1978 until November 1980, 169 previously untreated patients with advanced epithelial ovarian cancer were entered into a prospective randomized clinical trial comparing the combination of hexamethylmelamine, Adriamycin, and cyclophosphamide (HAC) to a combination of melphalan and cis-platinum. Eleven patients were excluded from analysis and another 5 patients were excluded from response analysis. Of 153 patients evaluable for response, there were 47, or 30.7%, complete responders (all determined surgically), 6 partial responders, and 100 nonresponders. The response rate for the HAC group was 31% and for the melphalan-platinum group was 37.8%. The overall response rate was 34.6%. Residual tumor diameter (less than or greater than 2 cm) exerted a statistically significant effect on response-47.8 vs 24.4%. Of the 47 complete responders, 7, or 14.9%, have relapsed, with the median duration of remission of 44+ months. Of the 158 patients evaluable for survival, 90 patients have died, with a median survival time of 27.9 months (HAC = 26.4 months, melphalan-platinum = 29.6 months). Age, FIGO stage, histologic grade, and residual disease all exerted a significant effect on survival time. Second-line therapy in the treatment failures was of no benefit. Hematologic toxicity was greater in the melphalan-platinum group. Gastrointestinal toxicity was severe in both groups. Other toxicities were minor and infrequent.

Original languageEnglish (US)
Pages (from-to)261-277
Number of pages17
JournalGynecologic Oncology
Volume15
Issue number2
DOIs
StatePublished - Jan 1 1983
Externally publishedYes

Fingerprint

Altretamine
Melphalan
Ovarian Neoplasms
Doxorubicin
Cyclophosphamide
Cisplatin
Randomized Controlled Trials
Platinum
Survival
Residual Neoplasm
Treatment Failure

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

A prospective randomized clinical trial of melphalan and cis-platinum versus hexamethylmelamine, adriamycin, and cyclophosphamide in advanced ovarian cancer. / Edwards, Creighton L.; Herson, Jay; Gershenson, David M.; Copeland, Larry J.; Wharton, J. Taylor.

In: Gynecologic Oncology, Vol. 15, No. 2, 01.01.1983, p. 261-277.

Research output: Contribution to journalArticle

Edwards, Creighton L. ; Herson, Jay ; Gershenson, David M. ; Copeland, Larry J. ; Wharton, J. Taylor. / A prospective randomized clinical trial of melphalan and cis-platinum versus hexamethylmelamine, adriamycin, and cyclophosphamide in advanced ovarian cancer. In: Gynecologic Oncology. 1983 ; Vol. 15, No. 2. pp. 261-277.
@article{86708bd800eb46159864c8549eaced1d,
title = "A prospective randomized clinical trial of melphalan and cis-platinum versus hexamethylmelamine, adriamycin, and cyclophosphamide in advanced ovarian cancer",
abstract = "From May 1978 until November 1980, 169 previously untreated patients with advanced epithelial ovarian cancer were entered into a prospective randomized clinical trial comparing the combination of hexamethylmelamine, Adriamycin, and cyclophosphamide (HAC) to a combination of melphalan and cis-platinum. Eleven patients were excluded from analysis and another 5 patients were excluded from response analysis. Of 153 patients evaluable for response, there were 47, or 30.7{\%}, complete responders (all determined surgically), 6 partial responders, and 100 nonresponders. The response rate for the HAC group was 31{\%} and for the melphalan-platinum group was 37.8{\%}. The overall response rate was 34.6{\%}. Residual tumor diameter (less than or greater than 2 cm) exerted a statistically significant effect on response-47.8 vs 24.4{\%}. Of the 47 complete responders, 7, or 14.9{\%}, have relapsed, with the median duration of remission of 44+ months. Of the 158 patients evaluable for survival, 90 patients have died, with a median survival time of 27.9 months (HAC = 26.4 months, melphalan-platinum = 29.6 months). Age, FIGO stage, histologic grade, and residual disease all exerted a significant effect on survival time. Second-line therapy in the treatment failures was of no benefit. Hematologic toxicity was greater in the melphalan-platinum group. Gastrointestinal toxicity was severe in both groups. Other toxicities were minor and infrequent.",
author = "Edwards, {Creighton L.} and Jay Herson and Gershenson, {David M.} and Copeland, {Larry J.} and Wharton, {J. Taylor}",
year = "1983",
month = "1",
day = "1",
doi = "10.1016/0090-8258(83)90082-3",
language = "English (US)",
volume = "15",
pages = "261--277",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "2",

}

TY - JOUR

T1 - A prospective randomized clinical trial of melphalan and cis-platinum versus hexamethylmelamine, adriamycin, and cyclophosphamide in advanced ovarian cancer

AU - Edwards, Creighton L.

AU - Herson, Jay

AU - Gershenson, David M.

AU - Copeland, Larry J.

AU - Wharton, J. Taylor

PY - 1983/1/1

Y1 - 1983/1/1

N2 - From May 1978 until November 1980, 169 previously untreated patients with advanced epithelial ovarian cancer were entered into a prospective randomized clinical trial comparing the combination of hexamethylmelamine, Adriamycin, and cyclophosphamide (HAC) to a combination of melphalan and cis-platinum. Eleven patients were excluded from analysis and another 5 patients were excluded from response analysis. Of 153 patients evaluable for response, there were 47, or 30.7%, complete responders (all determined surgically), 6 partial responders, and 100 nonresponders. The response rate for the HAC group was 31% and for the melphalan-platinum group was 37.8%. The overall response rate was 34.6%. Residual tumor diameter (less than or greater than 2 cm) exerted a statistically significant effect on response-47.8 vs 24.4%. Of the 47 complete responders, 7, or 14.9%, have relapsed, with the median duration of remission of 44+ months. Of the 158 patients evaluable for survival, 90 patients have died, with a median survival time of 27.9 months (HAC = 26.4 months, melphalan-platinum = 29.6 months). Age, FIGO stage, histologic grade, and residual disease all exerted a significant effect on survival time. Second-line therapy in the treatment failures was of no benefit. Hematologic toxicity was greater in the melphalan-platinum group. Gastrointestinal toxicity was severe in both groups. Other toxicities were minor and infrequent.

AB - From May 1978 until November 1980, 169 previously untreated patients with advanced epithelial ovarian cancer were entered into a prospective randomized clinical trial comparing the combination of hexamethylmelamine, Adriamycin, and cyclophosphamide (HAC) to a combination of melphalan and cis-platinum. Eleven patients were excluded from analysis and another 5 patients were excluded from response analysis. Of 153 patients evaluable for response, there were 47, or 30.7%, complete responders (all determined surgically), 6 partial responders, and 100 nonresponders. The response rate for the HAC group was 31% and for the melphalan-platinum group was 37.8%. The overall response rate was 34.6%. Residual tumor diameter (less than or greater than 2 cm) exerted a statistically significant effect on response-47.8 vs 24.4%. Of the 47 complete responders, 7, or 14.9%, have relapsed, with the median duration of remission of 44+ months. Of the 158 patients evaluable for survival, 90 patients have died, with a median survival time of 27.9 months (HAC = 26.4 months, melphalan-platinum = 29.6 months). Age, FIGO stage, histologic grade, and residual disease all exerted a significant effect on survival time. Second-line therapy in the treatment failures was of no benefit. Hematologic toxicity was greater in the melphalan-platinum group. Gastrointestinal toxicity was severe in both groups. Other toxicities were minor and infrequent.

UR - http://www.scopus.com/inward/record.url?scp=0020586514&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0020586514&partnerID=8YFLogxK

U2 - 10.1016/0090-8258(83)90082-3

DO - 10.1016/0090-8258(83)90082-3

M3 - Article

C2 - 6403413

AN - SCOPUS:0020586514

VL - 15

SP - 261

EP - 277

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 2

ER -