“I think it’s really important that people keep signing up to these type of trials to push research forward.”
A trial looking at chemotherapy before and after surgery for advanced peritoneal cancer (Neo-ESCAPE)
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This trial was looking at giving chemotherapy before and after surgery for cancer of the ovary, fallopian tube or peritoneum. The trial was supported by Cancer Research UK.
But if the cancer is at a more advanced stage when it is diagnosed, it may not be possible to remove it with surgery. You may have chemotherapy first to shrink the tumour so that surgery might be possible later on.
But from research, doctors thought that having the drugs separately may be better. Women taking part in this trial had carboplatin first, followed by paclitaxel.
The researchers also wanted to see if adding in another drug called gemcitabine would make it possible for more women to have surgery to remove their cancer. In this trial, women had gemcitabine at the same time as one of the other chemotherapy drugs.
The aims of the trial were to
- Find out if it was possible to give chemotherapy in this way
- See how many women were able to complete the treatment
- See how many of the women were able to have surgery
- Learn more about the side effects
Summary of results
The trial team found that cancer responded to the chemotherapy in more than 7 out of 10 women who had carboplatin, followed by paclitaxel and gemcitabine. And nearly 8 out of 10 women who had this type of chemotherapy completed their planned treatment.
The trial recruited 75 women who had cancer of the ovary, fallopian tube or peritoneum that was stage 3C or stage 4. They were not able have surgery as their first treatment.
The plan was for women to have 6 cycles of chemotherapy and then an assessment to see if they could have surgery. If they had surgery, they then had another 6 cycles of chemotherapy afterwards.
If they weren’t able to have surgery after 6 cycles of treatment, they carried on and had another 6 cycles of chemotherapy. Their doctors would then see if they could have surgery at the end of the 12th treatment cycle.
The trial was randomised. The women were put into groups by computer. Neither they nor their doctor could decide which group they were in. The plan for the trial was as follows
- Women in the first group were to have a combination of carboplatin and gemcitabine for the first 6 cycles, followed by paclitaxel alone for the next 6 cycles
- Women in the second group were to have carboplatin alone for the first 6 cycles, followed by paclitaxel and gemcitabine for the next 6
The trial stopped recruiting women into the first group as some early results showed this was not helping them.
Of the 28 women in the first group, only half completed all 12 cycles of treatment. The main reason for stopping treatment early was because of bad side effects.
Of the 47 women in the second group, 37 completed all 12 cycles of treatment. The main reason women in this group stopped having treatment early was because their cancer was getting worse.
More than half the women were able to have surgery as planned after 6 cycles of chemotherapy.
The researchers concluded that carboplatin followed by paclitaxel and gemcitabine could be used for women with advanced ovarian, fallopian tube or peritoneal cancer who can’t have surgery as their first treatment.
We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (
How to join a clinical trial
Professor Christopher Poole
Cancer Research UK
National Institute for Health Research Cancer Research Network (NCRN)
University of Birmingham
University of Warwick
Warwick Medical School
This is Cancer Research UK trial number CRUK/06/020.