Efficacy and safety of Carboplatin with Pemetrexed or Paclitaxel for frail women with advanced ovarian, peritoneal, or fallopian tube cancer: an open-label, randomized, phase 2 trial

Epithelial ovarian cancer is the third most common cancer in Indian women, with high mortality. Frail patients experience excessive toxicity from standard carboplatin-paclitaxel, while single-agent carboplatin yields inferior outcomes. Pemetrexed, with its favorable safety profile and efficacy in relapsed disease, may offer a better-tolerated alternative. This trial evaluates whether carboplatin-pemetrexed improves tolerability without compromising efficacy compared to standard therapy in frail patients (Frailty Index more than or equal to 0.15).This study tests whether a gentler chemotherapy combo (carboplatin-pemetrexed) works as well as standard treatment but with fewer side effects in frail ovarian cancer patients. If successful, it could offer a safer option for frail women.