Hexa-CAF combination chemotherapy and other multiple-drug regimens in advanced ovarian carcinoma: Present and future

In patients with advanced ovarian carcinoma, combination chemotherapy seems to be superior to monotherapy with melphalan. This paper discusses our experience with the Hexa-CAF combination, and the results obtained in 27 evaluable patients. As first-line chemotherapy the Hexa-CAF schedule gives improved response rates, but an increase in overall survival has not yet been shown. In previously treated patients the Hexa-CAF combination is not useful because of the poor response rate and the severe toxicity. Two interesting new combinations containing cis-platinum diaminodichloride (CDDP) are promising alternatives for these patients. In previously untreated patients, favourable results can be expected from the combinations under study with hexamethylmelamine, adriamycin, and CDDP. Until more data are available treatment with combination chemotherapy ought to be restricted to specialized centres. Apart from new powerful drug combinations, the outlook for the patient with advanced ovarian carcinoma can be improved by surgical resection of the main bulk of the tumour prior to chemotherapy.