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Survival impact of extended cycles of second-line chemotherapy in platinum-sensitive relapsed ovarian cancer patients with residual tumor after six cycles.


ABSTRACT: Background: To determine if extended chemotherapy improves survival outcomes in patients with platinum-sensitive relapsed epithelial ovarian cancer (EOC) who have residual disease after six cycles of second-line chemotherapy.

Methods: In this study, 135 EOC patients who experienced platinum-sensitive recurrence after primary treatment between 2008 and 2018, and had a residual tumor ?0.5?cm (detected on CT scans) after completing six cycles of second-line, platinum-based chemotherapy, were retrospectively reviewed. Based on the number of main therapy cycles (second-line chemotherapy), we divided patients into an extended group (>6?cycles, n?=?52) or a standard group (6?cycles, n?=?83) and compared patient characteristics and survival outcomes between these groups.

Results: The extended group had a shorter platinum-free interval after primary treatment than the standard group (median, 11.0 vs. 13.1?months; P?=?0.018). Secondary debulking surgery was less frequently performed in the standard group (1.9% vs. 19.3%; P?=?0.003). After six chemotherapy cycles, the extended and standard groups showed similar serum CA-125 levels (P?=?0.122) and residual tumor sizes (P?=?0.232). There was no difference in overall survival (OS) between the groups (P?=?0.382), although the extended group had significantly worse progression-free survival (PFS) than the standard group (median, 13.9 vs. 15.1?months; P?=?0.012). Multivariate analyses revealed that platinum-free interval was an independent prognostic factor for PFS and OS, but extended chemotherapy was not (PFS: HR, 1.25; 95% CI, 0.84-1.85; P?=?0.279; and OS: HR, 1.36; 95% CI, 0.72-2.56; P?=?0.342). We observed consistent results in the subset of patients who did not undergo secondary debulking surgery.

Conclusions: More than six cycles of platinum-based chemotherapy might not improve survival outcomes in patients with platinum-sensitive recurrent EOC who had a residual tumor ?0.5?cm after six cycles of second-line chemotherapy.

SUBMITTER: Kim SI 

PROVIDER: S-EPMC7720565 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Survival impact of extended cycles of second-line chemotherapy in platinum-sensitive relapsed ovarian cancer patients with residual tumor after six cycles.

Kim Se Ik SI   Hwang Woo Yeon WY   Lee Maria M   Kim Hee Seung HS   Kim Kidong K   Chung Hyun Hoon HH   No Jae Hong JH   Kim Jae-Weon JW   Kim Yong Beom YB   Park Noh Hyun NH   Song Yong-Sang YS   Suh Dong Hoon DH  

BMC cancer 20201207 1


<h4>Background</h4>To determine if extended chemotherapy improves survival outcomes in patients with platinum-sensitive relapsed epithelial ovarian cancer (EOC) who have residual disease after six cycles of second-line chemotherapy.<h4>Methods</h4>In this study, 135 EOC patients who experienced platinum-sensitive recurrence after primary treatment between 2008 and 2018, and had a residual tumor ≥0.5 cm (detected on CT scans) after completing six cycles of second-line, platinum-based chemotherapy  ...[more]

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