Oncologists Nix High-Dose Chemo for Ovarian Ca.

SOUTH LAKE TAHOE, NEV. -- The strategy of using high-dose chemotherapy and bone marrow transplantation in ovarian cancer has been abandoned by most oncologists, Dr. Sidney Scudder said at an obstetrics and gynecology conference sponsored by the University of California, Davis.

At this point the best chance of improving ovarian cancer survival rates appears to lie with intraperitoneal chemotherapy or new drugs, said Dr. Scudder of the division of hematology and oncology at the university.

Up until fairly recently, the strategy of high-dose chemotherapy followed by stem cell transplantation enjoyed significant support among oncologists, but that sup port has now waned.

In breast cancer a number of recent trials have found no advantage to high-dose chemotherapy and stem cell transplantation. That data have diminished enthusiasm for the use of high-dose chemotherapy in any solid tumors.

There were a number of reasons for considering ovarian cancer a good candidate for high-dose chemotherapy-bone marrow transplantation strategy, Dr. Scudder noted. Ovarian tumors tend to be highly responsive to chemotherapeutic drugs, and ovarian cancer patients are often younger than other cancer patients and therefore have the strength to withstand the rigors of highly toxic treatment.

While small studies suggested that high-dose therapy benefited ovarian cancer patients, a large randomized trial was never done. The Gynecologic Oncology Group, a consortium of investigators, had planned such a trial but had a hard time recruiting patients. The trial was designed to enroll patients who had already gone through chemotherapy and failed. But patients were unwilling to be randomized to the control arm of that study, which was ...