Combination Chemotherapy Regimens in Ovarian Epithelial Cancer, Primary Peritoneal Cancer, or Fallopian Tube Cancer

DISEASE CHARACTERISTICS:

• Histologically confirmed stage IIB-IV ovarian epithelial, primary peritoneal, or fallopian tube cancer

  • No borderline ovarian tumors
  • Residual disease allowed

• Fine needle aspiration showing an adenocarcinoma is allowed instead of open or true-cut biopsy if the following are true:

  • Presence of pelvic mass AND
  • Omental cake or other metastasis larger than 2 cm in the upper abdomen unless proven stage IV disease AND
  • Serum CA 125/carcinoembryonic antigen ratio at least 25 (if less than 25, a barium enema or colonoscopy and gastroscopy or radiological examination of the stomach should be negative for primary tumor within 6 weeks of study) AND
  • Normal mammography within 6 weeks of study

PATIENT CHARACTERISTICS:

Age:

• 18 to 75

Performance status:

• ECOG 0-1

Life expectancy:

• At least 12 weeks

Hematopoietic:

• Granulocyte count at least 2,000/mm^3
• Platelet count at least 150,000/mm^3

Hepatic:

• Not specified

Renal:

• Creatinine no greater than upper limit of normal

Cardiovascular:

• No clinically relevant atrial or ventricular arrhythmias
• No myocardial infarction (MI) within the past 6 months (pretreatment ECG as only evidence of MI allowed)
• No history of second- or third-degree heart blocks unless pacemaker implanted
• History of first-degree heart block allowed

Other:

• Not pregnant or nursing
• Fertile patients must use effective contraception
• No complete bowel obstruction
• No prior allergic reaction to drugs containing Cremophor EL or compounds chemically related to study drugs
• No condition that would preclude high-volume saline diuresis
• No significant neurologic or psychiatric disorder that would preclude study compliance
• No active uncontrolled infection
• No neuropathy greater than grade 1
• No pre-existing hearing loss greater than grade 1
• No other concurrent serious illness or medical condition that would preclude study participation
• No other malignancy within the past 5 years except adequately treated nonmelanoma skin cancer or curatively treated carcinoma in situ of the cervix

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• No concurrent biological response modifiers or immunotherapy

• No concurrent prophylactic colony-stimulating factors (CSFs)

  • Concurrent therapeutic CSFs allowed

Chemotherapy:

• No prior chemotherapy for ovarian cancer
• No other concurrent cytotoxic agents

Endocrine therapy:

• No concurrent anticancer hormonal therapy

Radiotherapy:

• No prior radiotherapy for ovarian cancer

Surgery:

• No more than 6 weeks since prior planned pre-chemotherapy surgery for ovarian cancer
• Planned interval debulking allowed
• Concurrent second-look surgery allowed

Other:

• No prior non-surgical therapy for ovarian cancer
• No other concurrent investigational drug therapy
• No other concurrent anticancer treatment
• Concurrent enrollment on CAN-NCIC-OV13/EORTC 55971 allowed