The effect of older age on treatment outcomes in women with advanced ovarian cancer receiving chemotherapy: An NRG-Oncology/Gynecologic Oncology Group (GOG-0182-ICON5) ancillary study

Tiffany Y. Sia; William P. Tew; Christopher Purdy; Dennis S. Chi; Andrew W. Menzin; John L. Lovecchio; Michael A. Bookman; David E. Cohn; Deanna G. Teoh; Michael Friedlander; David Bender; David G. Mutch; David M. Gershenson; Krishnansu S. Tewari; Robert M. Wenham; Andrea E. Wahner Hendrickson; Roger B. Lee; Heidi J. Gray; Angeles Alvarez Secord; Linda Van Le; Stuart M. Lichtman

doi:10.1016/j.ygyno.2023.03.018

The effect of older age on treatment outcomes in women with advanced ovarian cancer receiving chemotherapy: An NRG-Oncology/Gynecologic Oncology Group (GOG-0182-ICON5) ancillary study

Tiffany Y. Sia, William P. Tew, Christopher Purdy, Dennis S. Chi, Andrew W. Menzin, John L. Lovecchio, Michael A. Bookman, David E. Cohn, Deanna G. Teoh, Michael Friedlander, David Bender, David G. Mutch, David M. Gershenson, Krishnansu S. Tewari, Robert M. Wenham, Andrea E. Wahner Hendrickson, Roger B. Lee, Heidi J. Gray, Angeles Alvarez Secord, Linda Van LeStuart M. Lichtman

Obstetrics, Gynecology and Women's Health - Oncology

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Abstract

Objective: To assess the effect of age on overall survival (OS) in women with ovarian cancer receiving chemotherapy. Secondary objectives were to describe the effect of age on treatment compliance, toxicities, progression free survival (PFS), time from surgery to chemotherapy, and rates of optimal cytoreduction. Methods: Women enrolled in GOG 0182-ICON5 with stage III or IV epithelial ovarian cancer (EOC) who underwent surgery and chemotherapy between 2001 and 2004 were included. Patients were divided into ages <70 and ≥ 70 years. Baseline characteristics, treatment compliance, toxicities, and clinical outcomes were compared. Results: We included a total of 3686 patients, with 620 patients (16.8%) ≥ 70 years. OS was 37.2 months in older compared to 45.0 months in younger patients (HR 1.21, 95% CI, 1.09–1.34, p < 0.001). Older patients had an increased risk of cancer-specific-death (HR 1.16, 95% CI, 1.04–1.29) as well as non-cancer related deaths (HR 2.78, 95% CI, 2.00–3.87). Median PFS was 15.1 months in older compared to 16.0 months in younger patients (HR 1.10, 95% CI, 1.00–1.20, p = 0.056). In the carboplatin/paclitaxel arm, older patients were just as likely to complete therapy and more likely to develop grade ≥ 2 peripheral neuropathy (35.7 vs 19.7%, p < 0.001). Risk of other toxicities remained equal between groups. Conclusions: In women with advanced EOC receiving chemotherapy, age ≥ 70 was associated with shorter OS and cancer specific survival. Older patients receiving carboplatin and paclitaxel reported higher rates of grade ≥ 2 neuropathy but were not more likely to suffer from other chemotherapy related toxicities. Clintrials.gov:

Original language	English (US)
Pages (from-to)	130-137
Number of pages	8
Journal	Gynecologic oncology
Volume	173
DOIs	https://doi.org/10.1016/j.ygyno.2023.03.018
State	Published - Jun 2023

Bibliographical note

Funding Information:
This study was supported by National Cancer Institute grants to NRG Oncology (1 U10 CA180822), NRG Operations (U10CA180868) as well as NIH/NCI Cancer Center Support Grant P30 CA008748, SWOG (U10CA180888). The following Gynecologic Oncology Group member institutions participated in the primary treatment studies: University of Alabama at Birmingham, Oregon Health Sciences University, Duke University Medical Center, Abington Memorial Hospital, University of Rochester Medical Center, Walter Reed Army Medical Center, Wayne State University, University of Minnesota Medical School, University of Southern California at Los Angeles, University of Mississippi Medical Center, Colorado Gynecologic Oncology Group P.C. University of California at Los Angeles, University of Washington, University of Pennsylvania Cancer Center, University of Miami School of Medicine, Milton S. Hershey Medical Center, Georgetown University Hospital, University of Cincinnati, University of North Carolina School of Medicine, University of Iowa Hospitals and Clinics, University of Texas Southwestern Medical Center at Dallas, Indiana University School of Medicine, Wake Forest University School of Medicine, Albany Medical College, University of California Medical Center at Irvine, Tufts-New England Medical Center, Rush-Presbyterian-St. Luke's Medical Center, University of Kentucky, Eastern Virginia Medical School, The Cleveland Clinic Foundation, Johns Hopkins Oncology Center, State University of New York at Stony Brook, Eastern Pennsylvania GYN/ONC Center, P.C. Southwestern Oncology Group, Washington University School of Medicine, Memorial Sloan Kettering Cancer Center, Columbus Cancer Council, University of Massachusetts Medical School, Fox Chase Cancer Center, Medical University of South Carolina, Women's Cancer Center, University of Oklahoma, University of Virginia Health Sciences Center, University of Chicago, University of Arizona Health Science Center, Tacoma General Hospital, Eastern Collaborative Oncology Group, Thomas Jefferson University Hospital, Case Western Reserve University, and Tampa Bay Cancer Consortium.

Funding Information:
This study was supported by National Cancer Institute grants to NRG Oncology ( 1 U10 CA180822 ), NRG Operations ( U10CA18086 8) as well as NIH / NCI Cancer Center Support Grant P30 CA008748 , SWOG (U10CA180888 ).

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© 2023 Elsevier Inc.

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Sia, T. Y., Tew, W. P., Purdy, C., Chi, D. S., Menzin, A. W., Lovecchio, J. L., Bookman, M. A., Cohn, D. E., Teoh, D. G., Friedlander, M., Bender, D., Mutch, D. G., Gershenson, D. M., Tewari, K. S., Wenham, R. M., Wahner Hendrickson, A. E., Lee, R. B., Gray, H. J., Secord, A. A., ... Lichtman, S. M. (2023). The effect of older age on treatment outcomes in women with advanced ovarian cancer receiving chemotherapy: An NRG-Oncology/Gynecologic Oncology Group (GOG-0182-ICON5) ancillary study. Gynecologic oncology, 173, 130-137. https://doi.org/10.1016/j.ygyno.2023.03.018

The effect of older age on treatment outcomes in women with advanced ovarian cancer receiving chemotherapy: An NRG-Oncology/Gynecologic Oncology Group (GOG-0182-ICON5) ancillary study. / Sia, Tiffany Y.; Tew, William P.; Purdy, Christopher et al.
In: Gynecologic oncology, Vol. 173, 06.2023, p. 130-137.

Research output: Contribution to journal › Article › peer-review

Sia, TY, Tew, WP, Purdy, C, Chi, DS, Menzin, AW, Lovecchio, JL, Bookman, MA, Cohn, DE, Teoh, DG, Friedlander, M, Bender, D, Mutch, DG, Gershenson, DM, Tewari, KS, Wenham, RM, Wahner Hendrickson, AE, Lee, RB, Gray, HJ, Secord, AA, Van Le, L & Lichtman, SM 2023, 'The effect of older age on treatment outcomes in women with advanced ovarian cancer receiving chemotherapy: An NRG-Oncology/Gynecologic Oncology Group (GOG-0182-ICON5) ancillary study', Gynecologic oncology, vol. 173, pp. 130-137. https://doi.org/10.1016/j.ygyno.2023.03.018

@article{78b287ccfb104fc8a6b6f31867cea307,

title = "The effect of older age on treatment outcomes in women with advanced ovarian cancer receiving chemotherapy: An NRG-Oncology/Gynecologic Oncology Group (GOG-0182-ICON5) ancillary study",

abstract = "Objective: To assess the effect of age on overall survival (OS) in women with ovarian cancer receiving chemotherapy. Secondary objectives were to describe the effect of age on treatment compliance, toxicities, progression free survival (PFS), time from surgery to chemotherapy, and rates of optimal cytoreduction. Methods: Women enrolled in GOG 0182-ICON5 with stage III or IV epithelial ovarian cancer (EOC) who underwent surgery and chemotherapy between 2001 and 2004 were included. Patients were divided into ages <70 and ≥ 70 years. Baseline characteristics, treatment compliance, toxicities, and clinical outcomes were compared. Results: We included a total of 3686 patients, with 620 patients (16.8%) ≥ 70 years. OS was 37.2 months in older compared to 45.0 months in younger patients (HR 1.21, 95% CI, 1.09–1.34, p < 0.001). Older patients had an increased risk of cancer-specific-death (HR 1.16, 95% CI, 1.04–1.29) as well as non-cancer related deaths (HR 2.78, 95% CI, 2.00–3.87). Median PFS was 15.1 months in older compared to 16.0 months in younger patients (HR 1.10, 95% CI, 1.00–1.20, p = 0.056). In the carboplatin/paclitaxel arm, older patients were just as likely to complete therapy and more likely to develop grade ≥ 2 peripheral neuropathy (35.7 vs 19.7%, p < 0.001). Risk of other toxicities remained equal between groups. Conclusions: In women with advanced EOC receiving chemotherapy, age ≥ 70 was associated with shorter OS and cancer specific survival. Older patients receiving carboplatin and paclitaxel reported higher rates of grade ≥ 2 neuropathy but were not more likely to suffer from other chemotherapy related toxicities. Clintrials.gov:",

author = "Sia, {Tiffany Y.} and Tew, {William P.} and Christopher Purdy and Chi, {Dennis S.} and Menzin, {Andrew W.} and Lovecchio, {John L.} and Bookman, {Michael A.} and Cohn, {David E.} and Teoh, {Deanna G.} and Michael Friedlander and David Bender and Mutch, {David G.} and Gershenson, {David M.} and Tewari, {Krishnansu S.} and Wenham, {Robert M.} and {Wahner Hendrickson}, {Andrea E.} and Lee, {Roger B.} and Gray, {Heidi J.} and Secord, {Angeles Alvarez} and {Van Le}, Linda and Lichtman, {Stuart M.}",

note = "Funding Information: This study was supported by National Cancer Institute grants to NRG Oncology (1 U10 CA180822), NRG Operations (U10CA180868) as well as NIH/NCI Cancer Center Support Grant P30 CA008748, SWOG (U10CA180888). The following Gynecologic Oncology Group member institutions participated in the primary treatment studies: University of Alabama at Birmingham, Oregon Health Sciences University, Duke University Medical Center, Abington Memorial Hospital, University of Rochester Medical Center, Walter Reed Army Medical Center, Wayne State University, University of Minnesota Medical School, University of Southern California at Los Angeles, University of Mississippi Medical Center, Colorado Gynecologic Oncology Group P.C. University of California at Los Angeles, University of Washington, University of Pennsylvania Cancer Center, University of Miami School of Medicine, Milton S. Hershey Medical Center, Georgetown University Hospital, University of Cincinnati, University of North Carolina School of Medicine, University of Iowa Hospitals and Clinics, University of Texas Southwestern Medical Center at Dallas, Indiana University School of Medicine, Wake Forest University School of Medicine, Albany Medical College, University of California Medical Center at Irvine, Tufts-New England Medical Center, Rush-Presbyterian-St. Luke's Medical Center, University of Kentucky, Eastern Virginia Medical School, The Cleveland Clinic Foundation, Johns Hopkins Oncology Center, State University of New York at Stony Brook, Eastern Pennsylvania GYN/ONC Center, P.C. Southwestern Oncology Group, Washington University School of Medicine, Memorial Sloan Kettering Cancer Center, Columbus Cancer Council, University of Massachusetts Medical School, Fox Chase Cancer Center, Medical University of South Carolina, Women's Cancer Center, University of Oklahoma, University of Virginia Health Sciences Center, University of Chicago, University of Arizona Health Science Center, Tacoma General Hospital, Eastern Collaborative Oncology Group, Thomas Jefferson University Hospital, Case Western Reserve University, and Tampa Bay Cancer Consortium. Funding Information: This study was supported by National Cancer Institute grants to NRG Oncology ( 1 U10 CA180822 ), NRG Operations ( U10CA18086 8) as well as NIH / NCI Cancer Center Support Grant P30 CA008748 , SWOG (U10CA180888 ). Publisher Copyright: {\textcopyright} 2023 Elsevier Inc.",

year = "2023",

month = jun,

doi = "10.1016/j.ygyno.2023.03.018",

language = "English (US)",

volume = "173",

pages = "130--137",

journal = "Gynecologic Oncology",

issn = "0090-8258",

publisher = "Academic Press Inc.",

}

TY - JOUR

T1 - The effect of older age on treatment outcomes in women with advanced ovarian cancer receiving chemotherapy

T2 - An NRG-Oncology/Gynecologic Oncology Group (GOG-0182-ICON5) ancillary study

AU - Sia, Tiffany Y.

AU - Tew, William P.

AU - Purdy, Christopher

AU - Chi, Dennis S.

AU - Menzin, Andrew W.

AU - Lovecchio, John L.

AU - Bookman, Michael A.

AU - Cohn, David E.

AU - Teoh, Deanna G.

AU - Friedlander, Michael

AU - Bender, David

AU - Mutch, David G.

AU - Gershenson, David M.

AU - Tewari, Krishnansu S.

AU - Wenham, Robert M.

AU - Wahner Hendrickson, Andrea E.

AU - Lee, Roger B.

AU - Gray, Heidi J.

AU - Secord, Angeles Alvarez

AU - Van Le, Linda

AU - Lichtman, Stuart M.

N1 - Funding Information: This study was supported by National Cancer Institute grants to NRG Oncology (1 U10 CA180822), NRG Operations (U10CA180868) as well as NIH/NCI Cancer Center Support Grant P30 CA008748, SWOG (U10CA180888). The following Gynecologic Oncology Group member institutions participated in the primary treatment studies: University of Alabama at Birmingham, Oregon Health Sciences University, Duke University Medical Center, Abington Memorial Hospital, University of Rochester Medical Center, Walter Reed Army Medical Center, Wayne State University, University of Minnesota Medical School, University of Southern California at Los Angeles, University of Mississippi Medical Center, Colorado Gynecologic Oncology Group P.C. University of California at Los Angeles, University of Washington, University of Pennsylvania Cancer Center, University of Miami School of Medicine, Milton S. Hershey Medical Center, Georgetown University Hospital, University of Cincinnati, University of North Carolina School of Medicine, University of Iowa Hospitals and Clinics, University of Texas Southwestern Medical Center at Dallas, Indiana University School of Medicine, Wake Forest University School of Medicine, Albany Medical College, University of California Medical Center at Irvine, Tufts-New England Medical Center, Rush-Presbyterian-St. Luke's Medical Center, University of Kentucky, Eastern Virginia Medical School, The Cleveland Clinic Foundation, Johns Hopkins Oncology Center, State University of New York at Stony Brook, Eastern Pennsylvania GYN/ONC Center, P.C. Southwestern Oncology Group, Washington University School of Medicine, Memorial Sloan Kettering Cancer Center, Columbus Cancer Council, University of Massachusetts Medical School, Fox Chase Cancer Center, Medical University of South Carolina, Women's Cancer Center, University of Oklahoma, University of Virginia Health Sciences Center, University of Chicago, University of Arizona Health Science Center, Tacoma General Hospital, Eastern Collaborative Oncology Group, Thomas Jefferson University Hospital, Case Western Reserve University, and Tampa Bay Cancer Consortium. Funding Information: This study was supported by National Cancer Institute grants to NRG Oncology ( 1 U10 CA180822 ), NRG Operations ( U10CA18086 8) as well as NIH / NCI Cancer Center Support Grant P30 CA008748 , SWOG (U10CA180888 ). Publisher Copyright: © 2023 Elsevier Inc.

PY - 2023/6

Y1 - 2023/6

N2 - Objective: To assess the effect of age on overall survival (OS) in women with ovarian cancer receiving chemotherapy. Secondary objectives were to describe the effect of age on treatment compliance, toxicities, progression free survival (PFS), time from surgery to chemotherapy, and rates of optimal cytoreduction. Methods: Women enrolled in GOG 0182-ICON5 with stage III or IV epithelial ovarian cancer (EOC) who underwent surgery and chemotherapy between 2001 and 2004 were included. Patients were divided into ages <70 and ≥ 70 years. Baseline characteristics, treatment compliance, toxicities, and clinical outcomes were compared. Results: We included a total of 3686 patients, with 620 patients (16.8%) ≥ 70 years. OS was 37.2 months in older compared to 45.0 months in younger patients (HR 1.21, 95% CI, 1.09–1.34, p < 0.001). Older patients had an increased risk of cancer-specific-death (HR 1.16, 95% CI, 1.04–1.29) as well as non-cancer related deaths (HR 2.78, 95% CI, 2.00–3.87). Median PFS was 15.1 months in older compared to 16.0 months in younger patients (HR 1.10, 95% CI, 1.00–1.20, p = 0.056). In the carboplatin/paclitaxel arm, older patients were just as likely to complete therapy and more likely to develop grade ≥ 2 peripheral neuropathy (35.7 vs 19.7%, p < 0.001). Risk of other toxicities remained equal between groups. Conclusions: In women with advanced EOC receiving chemotherapy, age ≥ 70 was associated with shorter OS and cancer specific survival. Older patients receiving carboplatin and paclitaxel reported higher rates of grade ≥ 2 neuropathy but were not more likely to suffer from other chemotherapy related toxicities. Clintrials.gov:

AB - Objective: To assess the effect of age on overall survival (OS) in women with ovarian cancer receiving chemotherapy. Secondary objectives were to describe the effect of age on treatment compliance, toxicities, progression free survival (PFS), time from surgery to chemotherapy, and rates of optimal cytoreduction. Methods: Women enrolled in GOG 0182-ICON5 with stage III or IV epithelial ovarian cancer (EOC) who underwent surgery and chemotherapy between 2001 and 2004 were included. Patients were divided into ages <70 and ≥ 70 years. Baseline characteristics, treatment compliance, toxicities, and clinical outcomes were compared. Results: We included a total of 3686 patients, with 620 patients (16.8%) ≥ 70 years. OS was 37.2 months in older compared to 45.0 months in younger patients (HR 1.21, 95% CI, 1.09–1.34, p < 0.001). Older patients had an increased risk of cancer-specific-death (HR 1.16, 95% CI, 1.04–1.29) as well as non-cancer related deaths (HR 2.78, 95% CI, 2.00–3.87). Median PFS was 15.1 months in older compared to 16.0 months in younger patients (HR 1.10, 95% CI, 1.00–1.20, p = 0.056). In the carboplatin/paclitaxel arm, older patients were just as likely to complete therapy and more likely to develop grade ≥ 2 peripheral neuropathy (35.7 vs 19.7%, p < 0.001). Risk of other toxicities remained equal between groups. Conclusions: In women with advanced EOC receiving chemotherapy, age ≥ 70 was associated with shorter OS and cancer specific survival. Older patients receiving carboplatin and paclitaxel reported higher rates of grade ≥ 2 neuropathy but were not more likely to suffer from other chemotherapy related toxicities. Clintrials.gov:

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The effect of older age on treatment outcomes in women with advanced ovarian cancer receiving chemotherapy: An NRG-Oncology/Gynecologic Oncology Group (GOG-0182-ICON5) ancillary study

Abstract

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