Gordon AN et al. (2004) Long-term survival advantage for women treated with pegylated liposomal doxorubicin compared with topotecan in a phase 3 randomized study of recurrent and refractory epithelial ovarian cancer. Gynecol Oncol 95: 1–8

Since cure is unlikely in most patients with recurrent ovarian cancer, treatments are aimed at prolonging survival while maintaining quality of life. A trend towards improved survival has been demonstrated in patients treated with pegylated liposomal doxorubicin compared with topotecan. Gordon et al. have recently completed their analysis of long-term survival data from the same study.

The analysis covered 474 women with epithelial ovarian cancer who either failed to respond to first-line, platinum-based chemotherapy or recurred after treatment. Patients subsequently randomized to pegylated liposomal doxorubicin (n = 239) had significantly better survival than those treated with topotecan (n = 235). Median survival was 62.7 and 59.7 weeks for the two groups, respectively. This corresponded to an 18% reduction in the risk of death in the pegylated liposomal doxorubicin group. Patients with platinum-sensitive disease (i.e. those who responded to initial treatment and were then progression-free for >6 months) were analyzed separately. These women showed a more pronounced survival benefit when treated with pegylated liposomal doxorubicin, with a 30% reduction in the risk of death compared with those in the topotecan group. For patients with platinum-refractory disease, there was no significant difference in survival between the two treatment groups.

In conclusion, pegylated liposomal doxorubicin significantly prolonged survival in this long-term study, compared with topotecan. The authors suggest that the drug should be treatment of choice for patients with relapsed ovarian cancer.