Adjuvant Hormonal Therapy Is Safe in Epithelial Ovarian Cancer

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Pre- or postmenopausal women with epithelial ovarian cancer can safely be treated with adjuvant hormone therapy.
Pre- or postmenopausal women with epithelial ovarian cancer can safely be treated with adjuvant hormone therapy.

Adjuvant hormonal therapy (AHT) in pre- or postmenopausal women with epithelial ovarian cancer is safe in women with ovarian cancer, as its use was associated with prolonged survival and relapse-free survival (RFS) in a study with more than 19 years of follow-up.

Women with ovarian cancer may experience menopausal-like symptoms such as osteoporosis, heart disease, or vasomotor disturbances such as hot flushes as a result of natural or treatment-induced menopause.1,2

A potential therapy for menopausal-like symptoms is hormone replacement therapy (HRT),2-4 but elevated risk of relapse due to HRT has been a concern.5

In the AHT trial, Rosalind A. Eeles, MD, of the Institute of Cancer Research in London, United Kingdom and colleagues sought to determine if patients with ovarian cancer could safely take HRT to improve menopausal-like symptoms after anticancer treatment.6

The trial was initiated in 1990 and, despite slow accrual that missed its goal, had a median follow-up time of 19.1 years.

Professor Judith Bliss, director of the Clinical Trials and Statistics Unit at the Institute of Cancer Research in London, and a coinvestigator of the study told Cancer Therapy Advisor that the safety of HRT in the setting of ovarian cancer is “an important question because first-line treatment for ovarian cancer usually begins in menopause in women yet to undergo it, and the symptoms can be especially severe because it is so sudden.”

Pre- and postmenopausal women with epithelial ovarian cancer of any stage were randomly assigned to receive AHT or not (control) after cancer treatment.

RELATED: BRCA1/2 Mutations Linked With Inherited Ovarian Cancer Risk

The primary endpoint was overall survival (OS) and relapse-free survival (RFS), defined as time from enrollment to all-cause mortality or relapse.

At baseline, the median age was 58.7, and most women had stage 3 cancer and were treated by single-agent platinum therapy. The intention-to-treat analysis included all 150 patients.

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