A Phase III Study of Cisplatin Plus Topotecan Followed by Paclitaxel Plus Carboplatin Versus Paclitaxel Plus Carboplatin as First Line Chemotherapy in Women With Newly Diagnosed Advanced Epithelial Ovarian Cancer

Inclusion Criteria

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