Objective. To determine the feasibility and efficacy of sequential gemcitabine- carboplatin followed by paclitaxel- carboplatin in the first- line treatment of advanced epit-helial ovarian cancer, with the response rate as the primary endpoint. Methods. After primary laparotomy, 56 patients with FIGO Stages III- IV disease were given 4 cycles of gemcitabine 1000 mg/m2 d1,8 and carboplatin AUC5 (44 patients) or AUC6 (12 patients) d1 q3wk followed by 4 cycles of paclitaxel 175 mg/m2 d1 and carboplatin AUC5/6 q3wk. Of the tumors, 43 were serous, 6 clear cell, 4 endometrioid, and 3 anaplastic type. Thirty- seven (66.1% ) of the patients were suboptimally debulked. Results. Forty-seven patients were evaluable for response by CA- 125 criteria, and 46 (98% ) responded. Thirty patients (after gemcitabine- carboplatin) and 24 (after paclitaxel- carboplatin) were evaluable for response by CT (RECIST criteria), respectively. After the four gemcitabine- carboplatin cycles, the objective response rate was 83% (6 CR, 19 PR). Following completion of the whole sequential regimen, 7 patients showed a CR and 15 a PR, respectively, giving a response rate of 92% . The median progression- free survival was 12.8 months after a median follow- up of 19 months (range 7- 35 months)- .The median overall survival has not been reached yet. The main toxicity was neutropenia as 139/221 (62.9% ) of the gemcitabine- carboplatin cycles and 92/181 (50.8% ) of the paclitaxel- carboplatin cycles, respectively, were associated with Grades 3- 4 neutropenia. Neutropenia was reported as a serious adverse event in 5.7% of the cycles, and GCSF support was needed in 18.4% of the cycles. Only the gemcitabine- carboplatin cycles were associated with a marked thrombocytopenia (32.1% Grades 3- 4). Of the other side effects, marked allergy occurred in 14/52 (27% ) exposed to paclitaxel. A total of 14 patients discontinued the treatment prematurely: 3 due to lack of efficacy, 1 due to protocol violation, and 10 due to toxicity (4 allergic reactions to paclitaxel, 3 complicated neutropenias, 1 fever, and 2 unspecified toxicities). The mean relative dose intensities were: gemcitabine 84.0% , paclitaxel 85.4% , and carboplatin 96.5% . Of the gemci-tabine- carboplatin cycles and paclitaxel- carboplatin cycles, 32% and 38% were delayed, respectively. Gemcitabine d8 dose had to be omitted in 8% of the cycles. Conclusion. The sequential regimen of gemcitabine- carboplatin followed by paclitaxel- carboplatin is feasible in chemotherapy- naive ovarian cancer. Although its use is associated with a marked neutropenia, the neutropenia is manageable. Objective. To determine the feasibility and efficacy of sequential gemcitabine- carboplatin followed by paclitaxel-carboplatin in the first-line treatment of advanced epit-helial ovarian cancer, with the response rate as the primary endpoint. Methods. After primary laparotomy, 56 patients with FIGO Stages III-IV disease were given 4 cycles of gemcitabine 1000 mg / m2 d1,8 and carboplatin AUC5 (44 patients) or AUC6 (12 patients) d1 q3wk followed by 4 cycles of paclitaxel 175 mg / m2 d1 and carboplatin AUC5 / 6 Of the tumors, 43 were serous, 6 clear cells, 4 endometrioid, and 3 anaplastic types. Thirty-seven (66.1%) of the patients were suboptimally debulked. Results. Forty-seven patients were evaluated for response by CA- 125 Critically, and 46 (98%) responded. Thirty patients (after gemcitabine carboplatin) and 24 (after paclitaxel carboplatin) were evaluable for response by CT (RECIST criteria), respectively. After the four gemcitabine- carboplatin cycles, the objective response r Following completion of the whole sequential regimen, 7 patients showed a CR and 15 a PR, respectively, giving a response rate of 92%. The median progression- free survival was 12.8 months after The median overall survival has not been reached yet. The main toxicity was neutropenia as 139/221 (62.9%) of the gemcitabine-carboplatin cycles and 92/181 (50.8%) of the paclitaxel-carboplatin cycles, respectively, were associated with Grades 3- 4 neutropenia. Neutropenia was reported as a serious adverse event in 5.7% of cycles, and GCSF support was needed in 18.4% of the cycles. Only The total number of patients who discontinued the treatment prematurely (32.1% Grades 3- 4). Of the other side effects, marked allergy occurred in 14/52 (27%) to paclitaxel. : 3 due to lack of efficacy, 1 due to protocol violation, and 10 dueto toxicity (4 allergic reactions to paclitaxel, 3 complicated neutropenias, 1 fever, and 2 unspecified toxicities). The mean relative dose intensities were: gemcitabine 84.0%, paclitaxel 85.4%, and carboplatin 96.5%. Of the gemci-tabine carboplatin cycles The sequential regimen of gemcitabine-carboplatin followed by paclitaxel-carboplatin is feasible in chemotherapy-naive ovarian cancer. Although its use is associated with a marked neutropenia, the neutropenia is manageable.