A multicenter trial has determined that Gemzar (gemcitabine) and Doxil (pegylated liposomal doxorubicin) are equally effective for the treatment of platinum-resistant ovarian cancer. The details of this randomized trial appeared in the July 1, 2007 issue of the Journal of Clinical Oncology.

For women who have failed first-line therapy for ovarian cancer there are many active agents, but there is no consensus as to which agent is most active or what schedule is most advantageous. Doxil and Gemzar are active single agents for the treatment of refractory or resistant ovarian cancer. Both are often combined or combined with other agents for the treatment of recurrent ovarian cancer but there have been no direct comparisons between the two agents.

In the current study, 195 women with ovarian cancer who had relapsed within 6 months of receiving platinum based chemotherapy were randomly allocated to salvage therapy with Gemzar or Doxil.  Cross over therapy was administered to 130 patients with equal numbers in both groups. The following table summarizes disease control (CR+PR +stable disease), progression-free survival (PFS), overall survival (OS) and time to treatment failure (TTF) for the two groups.

Disease control following crossover was 63.6% for the Doxil-Gemzar group and Gemzar-Doxil 45.3% for the doxil group.

Comments: These data indicate general equivalency for Gemzar and Doxil for the initial salvage therapy of platinum resistant ovarian cancer. There was a trend toward better disease control in patients receiving Gemzar. These results should be compared to combined use of these two agents vs sequential use.

Reference:  Mutch DG, Oriando M, Goss T, et al. Randomized phase III trial of gemcitabine compared with pegylated liposomal doxorubicin in patients with platinum-resistant ovarian cancer. Journal of Clinical Oncology. 2007; 19:2811-2818.

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