 A phase I study by the GOG combined paclitaxel, cisplatin, and doxorubicin with or without granulocyte colony-stimulating factor. A 46 response rate with this regimen determined the optimal dosing of the agents and led to a phase III GOG study GOG 177. GOG 177 demonstrated the combination of paclitaxel, doxorubicin and cisplatin to have higher response rates 57 vs. 33 over the combination of doxorubicin and cisplatin, but the three drug combination was associated with more toxicity and 12-month overall survival 58 vs. 50 was similar. Furthermore, more Grade 3 and 4 toxicity was experienced by patients that received the three drug combination, although this was not statistically significant. Accordingly, a phase III trial comparing the paclitaxel, doxorubicin, and cisplatin regimen to a more tolerable regimen of paclitaxel and carboplatin is planned by the GOG, based on equivalency studies in ovarian cancer patients where carboplatin was substituted for cisplatin and demonstrated easier administration with equal efficacy and less toxicity. 