What proportion of patients with stage 3 ovarian cancer are potentially cured following intraperitoneal chemotherapy? Analysis of the long term (≥10 years) survivors in NRG/GOG randomized clinical trials of intraperitoneal and intravenous chemotherapy in stage III ovarian cancer

Omali Pitiyarachchi, Michael Friedlander, James J. Java, John K. Chan, Deborah K. Armstrong, Maurie Markman, Thomas J. Herzog, Bradley J. Monk, Floor Backes, Angeles Alvarez Secord, Albert Bonebrake, Peter G. Rose, Krishnansu S. Tewari, Samuel S. Lentz, Melissa A. Geller, Larry J. Copeland, Robert S. Mannel

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

OBJECTIVE: Patients with advanced epithelial ovarian cancer (EOC) alive without progression at a landmark time-point of 10 years from diagnosis are likely cured. We report the proportion of patients with Stage III EOC who were long-term disease-free survivors (LTDFS≥10 years) following either intraperitoneal (IP) or intravenous (IV) chemotherapy as well as the predictors of LTDFS.

METHODS: Data from 3 mature NRG/GOG trials (104, 114, 172) were analyzed and included demographics, clinicopathologic details, route of administration, and survival outcomes of patients living ≥10 years assessed according to the Kaplan-Meier method. Cox regression survival analysis was performed to evaluate independent prognostic predictors of LTDFS.

RESULTS: Of 1174 patients randomized, 10-year overall survival (OS) was 26% (95% CI, 23-28%) and LTDFS ≥10 years was 18% (95% CI, 16-20%). Patients with LTDFS ≥10 years had a median age of 54.6 years (p < 0.001). Younger age (p < 0.001) was the only independent prognostic factor for LTDFS≥10 years on multivariate Cox analysis.

CONCLUSIONS: Approximately 18% of patients were LTDFS ≥10 years. They form the tail end of the survival curve and are likely cured. Our results provide a comparative benchmark to evaluate the impact of PARP inhibitors in 1st line maintenance trials on survival outcomes.

Original languageEnglish (US)
Pages (from-to)410-416
Number of pages7
JournalGynecologic oncology
Volume166
Issue number3
DOIs
StatePublished - Sep 2022

Bibliographical note

Funding Information:
MF reports honoraria from Astra Zeneca;GSK;Novartis;MSD;Takeda;Lilly;Eisei for advisory boards/consulting.Speaker fees from Astra Zeneca;GSK and MSD. Institutional research funding from Astra Zeneca;Novartis and Beigene. Travel expenses for Astra Zeneca.

Funding Information:
MF supported by NHMRC Program Grant APP1092856 .

Publisher Copyright:
© 2022 The Authors

Keywords

  • 10-year survival
  • Advanced ovarian cancer
  • Chemotherapy
  • Cancer Survivors
  • Humans
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Antineoplastic Combined Chemotherapy Protocols/therapeutic use
  • Disease-Free Survival
  • Ovarian Neoplasms/drug therapy
  • Carcinoma, Ovarian Epithelial/drug therapy
  • Female
  • Neoplasm Staging

PubMed: MeSH publication types

  • Research Support, Non-U.S. Gov't
  • Journal Article

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