Imperial College London
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ProfessorIainMcNeish

Faculty of Medicine, Department of Surgery & Cancer

Chair in Oncology
 
 
 
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Contact

 

+44 (0)20 7594 2185i.mcneish Website

 
 
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Assistant

 

Ms Sophie Lions +44 (0)20 7594 2792

 
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Location

 

G036Institute of Reproductive and Developmental BiologyHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{McNeish:2019,
author = {McNeish, I and Gabra, H},
journal = {The Lancet},
title = {ICON8: A GCIG phase III randomised controlled trial evaluating weekly dose- dense chemotherapy in first-line epithelial ovarian/fallopian tube/primary peritoneal carcinoma (EOC) treatment: primary progression free survival analysis results},
url = {http://hdl.handle.net/10044/1/73658},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background Carboplatin and paclitaxel administered every three weeks is standard-of-care first-line chemotherapy for epithelial ovarian cancer (EOC). The Japanese JGOG3016 trial demonstrated a significant improvement in progression-free (PFS) and overall survival (OS) with dose-dense weekly paclitaxel and three-weekly carboplatin. We compared efficacy and safety of two dose-dense weekly regimens to standard 3-weekly chemotherapy in a predominantly European EOC population. Methods In this phase 3 trial, women with newly diagnosed FIGO stage Ic-IV EOC were randomised 1:1:1 toArm 1 (carboplatin (AUC5/6) and paclitaxel (175mg/m2) every 3 weeks), Arm 2 (carboplatin (AUC5/6)every 3 weeks and paclitaxel (80mg/m2) weekly) or Arm 3 (carboplatin (AUC2) and paclitaxel (80mg/m2) weekly). Patients entered after immediate primary surgery, or prior to neo-adjuvant chemotherapy before planned delayed primary surgery. An intention-to-treat primary PFS efficacy analysis compared Arm 2 vs 1 and Arm 3 vs 1. Findings 1566 women were randomised. 72%, 60% and 63% completed 6 protocol-defined treatment cycles in Arms 1, 2 and 3 respectively, although 90%, 89% and 85% completed 6 platinum-based chemotherapy cycles. Paclitaxel dose-intensification was achieved with weekly treatment (mediantotal paclitaxel dose 1011; 1234; 1274 mg/m2). Although Grade 3/4 toxicity increased with weekly treatment, this was predominantly uncomplicated. Febrile neutropenia and sensory neuropathy incidences were similar across arms. By February 2017, 64% patients had experienced disease progression. No significant PFS increase was observed with either weekly regimen (log-rank Arm 2vs1 p=0.3532; Arm 3vs1 p=0.5130, non-proportionality p=0.0297, restricted mean survival time = 24.4; 24.9; 25.3 months in Arms 1, 2, 3 with 97.5% CI: 23.0 to 26.0; 24.0 to 25.9; 23.9 to 26.9 months respectively). Interpretation Weekly dose-dense chemotherapy can be delivered successfully as first-line EOC treatment but does not significa
AU  - McNeish,I
AU  - Gabra,H
PY  - 2019///
SN  - 0140-6736
TI  - ICON8: A GCIG phase III randomised controlled trial evaluating weekly dose- dense chemotherapy in first-line epithelial ovarian/fallopian tube/primary peritoneal carcinoma (EOC) treatment: primary progression free survival analysis results
T2  - The Lancet
UR  - http://hdl.handle.net/10044/1/73658
ER  -
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