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. 2022 Sep;166(3):410-416.
doi: 10.1016/j.ygyno.2022.07.004. Epub 2022 Jul 11.

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  1 , Michael Friedlander  2 , James J Java  3 , John K Chan  4 , Deborah K Armstrong  5 , Maurie Markman  6 , Thomas J Herzog  7 , Bradley J Monk  8 , Floor Backes  9 , Angeles Alvarez Secord  10 , Albert Bonebrake  11 , Peter G Rose  12 , Krishnansu S Tewari  13 , Samuel S Lentz  14 , Melissa A Geller  15 , Larry J Copeland  16 , Robert S Mannel  17
Affiliations

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 et al. Gynecol Oncol. 2022 Sep.

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.

Keywords: 10-year survival; Advanced ovarian cancer; Chemotherapy.

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Conflict of interest statement

Declaration of Competing Interest 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. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1.
Fig. 1.
Consort diagram of patients entered into GOG 104, 114 and 172 randomized to IP vs IV chemotherapy. Of 1174 patients in these 3 trials, 221 (18.8%) were reported to be alive ≥10 years from initial diagnosis and 160 (13.6%) were LTDFS ≥10 years and had not recurred.
Fig. 2.
Fig. 2.
Kaplan-Meier curve showing long-term overall survival (LTOS) ≥10 years and disease-free survival (LTDFS) ≥10 years.
See this image and copyright information in PMC

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