Combination of Bone Marrow Transplant and High-Dose Chemotherapy Improves Survival in Ovarian Cancer

Combining bone marrow transplant with high-dose chemotherapy improvessurvival rates for women with advanced ovarian cancer, accordingto researchers at Loyola University Medical Center, Chicago.

Of 30 women whose cancers failed to respond successfully to priorchemotherapy treatments and who then underwent the innovativetherapy, 23% remained alive and disease-free after 3 years. Onlyone death occurred during treatment.

"This represents a significant success, considering thatuntil now the long-term prognosis was essentially zero for a womanwho developed recurrent or drug-resistant ovarian cancer,"said Dr. Patrick Stiff, director of bone marrow transplantationat Loyola and the principal investigator of the study.

Program paticipants ranged in age from 30 to 64. Each receivedhigh doses of mitoxantrone (Novantrone), carboplatin (Paraplatin),and cyclophosphamide (Cytoxan, Neosar) after stem cells were firstremoved from their bone marrow. Following the high-dose chemotherapy,the preserved stem cells were reinfused in the patient.

"Right now, we are looking at survival rates of only 10%to 20% on average for ovarian cancer, when applying conventionaltreatments," Stiff indicated. "The use of Taxol mayimprove survival somewhat, but not by more than a few percentagepoints."

Nearly one-quarter of the study participants, all of whom weredrawn from the population of patients with recurrent or drug-resistantovarian cancer, remained disease-free even after 3 years, Stiffsaid. In fact, more than 80% of the patients initially experiencedremission of their cancers in response to the therapy; mediansurvival was 29 months.

"We are undertaking further studies to determine whetherusing this same combination of drugs and transplantation can improvesurvival rates even more when given to patients at the outset,before they have developed recurrent or drug-resistant stagesof the disease," Stiff said.

The study represents the second phase of work that Stiff beganin 1989 as the single largest program of its kind in the nation,according to a spokesperson for Loyola. The early work not onlyestablished the potential effectiveness of the combination therapybut also provided a profile of the patient who would likely benefitmost from the treatment.

A full report on the study appears in the June issue of GynecologicOncology.