This unit focuses on the development of new treatment strategies for patients with advanced stage ovarian cancer. Studies are conducted with patients with newly diagnosed disease, as well as with recurrent disease. Generally, studies have focused on the development of """"""""dose intensity"""""""" strategies and the use of colony stimulating factors. Studies have also been conducted using non-traditional agents with novel mechanisms of action, such as suramin and CAI (carboxy amido imidazole). Project Description: Studies in the Initial Therapy of Advanced Stage Disease: We have completed a phase II platinum dose intensity study in advanced stage disease, as initial systemic therapy after surgery. Recent studies elsewhere suggest that dose intensity may be important in small volume disease, but there is some question is large volume disease. In our study, drug doses were; carboplatin 600 mg/m2, cisplatin 100 mg/m2, and cytoxan 250 mg/m2. Carboplatin and cytoxan were given on day 1, cisplatin was given on day 8, and the cycle was repeated every 28 days. The pathologic complete response proportion was 11 of 25 overall (44%), and was 7 of 18 (39%) in suboptimal patients. This compares with an overall PCR rate of 26%, taken from a collected series detailed in DeVita's textbook of oncology. Platinum dose intensity in our study was more than twice that used in standard types of regimens. Patient tolerance was good. We have initiated a phase I study of taxol, cisplatin, and cytoxan in newly diagnosed patients. As of this writing, we have completed accrual to dose level two. Following this phase I, we will initiate a limited phase II study to assess potential response rate.
