A trial looking at chemotherapy before and after surgery for advanced peritoneal cancer (Neo-ESCAPE)

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 (peer reviewed ) but may not have been published in a medical journal.  The figures we quote above were provided by the trial team. We have not analysed the data ourselves.