Hormonal Maintenance May Improve PFS in Low-grade Ovarian Cancer
Hormonal maintenance therapy after primary treatment significantly prolonged progression-free survival compared with observation,
Hormonal maintenance therapy after primary treatment significantly prolonged progression-free survival compared with observation among women with stage II to IV low-grade serous carcinoma of the ovary or peritoneum, according to a study published in the Journal of Clinical Oncology.1
In the absence of prospective data suggesting otherwise, clinicians at University of Texas MD Anderson Cancer Center in Houston recommend that women with newly diagnosed stage II to IV low-grade serous cancer of the ovary or peritoneum receive platinum plus taxane chemotherapy after primary cytoreductive surgery.
Investigators examined outcomes in women treated with hormonal maintenance compared with observation after primary cytoreductive surgery and platinum-based chemotherapy in women with stage II to IV disease.
Investigators analyzed data from 203 patients with stage II to IV low-grade serous carcinoma of the ovary or peritoneum who received care at MD Anderson Cancer Center between 1981 and 2013. Of those, 70 patients received hormonal maintenance therapy and 133 underwent observation.
The majority of patients received letrozole, about a quarter had tamoxifen, 5 patients had leuprolide acetate, and 2 received anastrozole as maintenance therapy.
Median follow-up was 70.8 months overall. Women who received hormonal maintenance therapy had a 56% lower risk of disease progression compared with those who underwent observation (hazard ratio, 0.44; 95% CI, 0.31-0.64; P < .001).
Median progression-free survival was 64.9 months for patients who received hormonal maintenance therapy vs 26.4 months for those who underwent observation (P < .001). There was no significant difference in overall survival between the 2 groups.
Among women who were disease free, median progression-free survival was significantly better for those who underwent hormonal maintenance therapy (81.1 vs 30.0 months; P < .001). Similarly, hormonal maintenance was associated with significantly improved progression-free survival in women with persistent disease (38.5 vs 15.2 months; P < .001).
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These potentially practice changing findings warrant further investigation of hormonal maintenance therapy in this population.
- Gershenson DM, Bodurka DC, Coleman RL, Lu KH, Malpica A, Sun CC. Hormonal maintenance therapy for women with low-grade serous cancer of the ovary or peritoneum. J Clin Oncol. 2017 Feb 21. doi: 10.1200/JCO.2016.71.0632 [Epub ahead of print]