 The combination of hormonal agents with cytotoxic chemotherapy has also been investigated. These studies utilized various combinations of non-taxane based cytotoxic chemotherapy in addition to megesterol or medroxyprogesterone acetate. Patients had response rates that varied from 33 to 60, with the combination cyclophosphamide, doxorubicin, cisplatin and megesterol producing the greatest response rate. Additionally, Pinelli et al. reported a 56 complete or partial response rate in a group of patients treated with carboplatin and sequential hormonal therapy with megesterol and tamoxifen. These studies suggest that sequential administration of hormonal therapy with chemotherapy has no detrimental effects on patients, and may be beneficial as hormonal therapy is generally less toxic than chemotherapy. Based on known tolerability and efficacy, investigating the combination of megesterol acetate with paclitaxel and carboplatin chemotherapy appears to be a reasonable option in the setting of advanced or recurrent endometrial cancer. 