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ICON8 trial shows having chemotherapy every week is no better than having it every three weeks for ovarian cancer

02 Dec 2019

Results from the ICON8 trial show that, for women with ovarian cancer, having chemotherapy every week is no better at preventing the cancer coming back or getting worse than having it every three weeks. These results were published last week in The Lancet journal.

ICON8 was a large international trial looking at whether having smaller doses of chemotherapy more often could help women with epithelial ovarian, fallopian tube, or primary peritoneal cancer. These women are usually treated with two chemotherapy drugs, which are given once every three weeks.

Evidence from a previous study in Japan suggested having smaller doses of chemotherapy more frequently might increase how long women with these cancers live, but might also increase side-effects. ICON8 looked at whether this would be the case in women from other countries.

Women who agreed to take part in ICON8 were allocated at random to one of three groups:

  • Standard chemotherapy with the drugs carboplatin and paclitaxel, given once every three weeks, for a total of 18 weeks
  • Weekly chemotherapy, with carboplatin still given every three weeks, but with paclitaxel given once a week (at a lower dose), for a total of 18 weeks
  • Weekly chemotherapy, with both carboplatin and paclitaxel given once a week (at a lower dose), for a total of 18 weeks

The chemotherapy was given either after surgery, or for nine weeks before and nine weeks after surgery.

A total of 1566 women took part in the study, joining between June 2011 and November 2014. Most of the women were from the UK, but some women from South Korea, the Republic of Ireland, Mexico, Australia and New Zealand also took part.

By February 2017, two in every three women in the trial had had their cancer come back or get worse. There was no evidence that being in either of the groups who had chemotherapy every week made any difference to when this happened.

On average, women who had chemotherapy every three weeks had around 24 months before their cancer came back or got worse. Women who had carboplatin every three weeks, and paclitaxel every week, had around 25 months before their cancer came back or got worse, on average. Women who had both carboplatin and paclitaxel every week also had around 25 months, on average, before their cancer came back or got worse. This difference is not big enough for us to be confident that having weekly chemotherapy is better than having chemotherapy once every three weeks.

Side-effects from chemotherapy were common. Overall, there was no difference between the groups in the number of women having a severe side-effect. However, women who had carboplatin once a week, and paclitaxel once every three weeks were more likely to have severe anaemia than women in the other groups.

These results suggest that there is no benefit to weekly chemotherapy for these women in terms of preventing their disease getting worse. The researchers are continuing to follow-up these women to see if there is any difference in how long women in any of these groups live.

The ICON8 trial was funded by Cancer Research UK.

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