Place du paclitaxel (Taxol®) lors de la chimiotherapie de premiere ligne des adenocarcinomes ovariens

Principle: This review analyzes the recent update of large international trials, in an attempt to more clearly define the role of paclitaxel in the first-line treatment of ovarian adenocarcinoma. Results: The results of the GOG 111 and of the canadian-european trials have demonstrated a therapeutic advantage for the association of cisplatin and paclitaxel over the reference regimen (cisplatin-cyclophosphamide), in the first line treatment of advanced ovarian cancer. This advantage was shown both in terms of therapeutic response rates and survival. The preliminary results of other trials suggest, in the same setting, an equivalence between a cisplatin-paclitaxel or a carboplatin-paclitaxel combination, with an therapeutic index in favor of the carboplatin-paclitaxel association. The exact role of the platinum compound and of paclitaxel in these associations is still under evaluation. Other ongoing studies are also presented, which aim to define the optimal treatment duration and modalities of paclitaxel administration, the potential interest of alternative therapeutic associations, as well as the role of paclitaxel in the treatment of earlier ovarian cancer. Conclusion: According to a majority of international experts, the association of a platinum compound to paclitaxel has become the new standard regimen (or one of the main options) in the first-line treatment of advanced ovarian cancer.