Single-agent adriamycin followed by combination hexamethylmelamine-cyclophosphamide for advanced ovarian carcinoma

Singleagent Adriamycin (ADM) induced a 21.8% response rate, surgically documented, in 32 previously untreated patients with advanced ovarian cancer. Patients with grade 3 carcinomas had a longer survival time than patients with grade 2 carcinomas (P = 0.07). A statistically significant interaction of grade and age was found (P = 0.01). Patients younger than 45 years had almost precisely the same risk of death per unit time, regardless of grade. Patients over age 45, with grade 3 tumors, had 3.6 times the risk of death per unit time, and those with grade 2 tumors had 45.5 times the risk as the patient under 45 years of age. Hexamethylmelamine-cyclophosphamide was active in four patients (17%) who failed to respond to ADM. ADM may exert significant but selective anti-tumor activity and deserves additional testing in drug combinations used in the treatment of ovarian cancer.