| The following article features coverage from the SGO 2022 Annual Meeting on Women’s Cancer. Click here to read more of Cancer Therapy Advisor’s conference coverage. |
Patients with stage II-III epithelial ovarian cancer can achieve long-term survival if they have no gross residual disease after primary cytoreductive surgery and go on to receive chemotherapy plus bevacizumab, according to a subanalysis of the phase 3 GOG 252 study.
Researchers observed a median overall survival (OS) of approximately 9 years, regardless of the chemotherapy regimen patients received.
The analysis also showed that having a CA-125 level less than 10 U/mL after 3 cycles of chemotherapy was associated with longer survival.
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These results were presented at the SGO 2022 Annual Meeting on Women’s Cancer by Joan L. Walker, MD, of Stephenson Cancer Center at the University of Oklahoma in Norman.
Trial Details
The GOG 252 trial (ClinicalTrials.gov Identifier: NCT00951496) included 1560 patients with stage II to III epithelial ovarian cancer who had no more than microscopic residual disease after primary cytoreductive surgery.
The patients were randomly assigned to receive:
- Intravenous (IV) paclitaxel plus carboplatin (IV carboplatin arm)
- IV paclitaxel plus intraperitoneal (IP) carboplatin (IP carboplatin arm)
- IV paclitaxel plus IP cisplatin and IP paclitaxel (IP cisplatin arm).
All patients also received bevacizumab during cycles 2 to 6, and then alone during cycles 7 to 22.
At baseline, the median age was 58 years, 90% of patients were White, 84% had stage III disease, 72% had grade 3 serous histology, and 57% had no residual disease after surgery.
Subanalysis Outcomes
Among the patients with no residual disease after surgery, the progression-free survival (PFS) was similar across the treatment arms. The median PFS was 35.9 months in the IV carboplatin arm, 35.8 months in the IP carboplatin arm, and 35.5 months in the IP cisplatin arm.
The OS was similar across the treatment arms as well. The median OS was 108.6 months in the IV carboplatin arm, 114.2 months in the IP carboplatin arm, and 107.9 months in the IP cisplatin arm.
Dr Walker noted that PFS and OS were prolonged for patients who had a CA-125 level less than 10 U/mL before the fourth cycle of chemotherapy.
The median PFS was 44.2 months for patients with a CA-125 level less than 10 U/mL and 28.5 months for patients with a higher CA-125 level. The median OS was not reached and 89.0 months, respectively.
Grade 3 or higher adverse events occurred in 90% of patients. In the IV carboplatin arm, 5.3% of patients developed grade 3 gastrointestinal fistula, necrosis, or leak, and 30% developed grade 2 or higher neuropathy.
In the IP cisplatin arm, 11.2% of patients had grade 3 nausea and vomiting, and 20.5% had grade 3 hypertension. Dr Walker did not present specific safety data for the IP carboplatin arm.
Dr Walker concluded that the results of this analysis showed “no difference by treatment arm in PFS and OS …, and patients with no gross residual disease lived a long time.”
“When you meet an ovarian cancer patient, you want to give them the opportunity to have a complete surgical resection and give them the opportunity to potentially live 10 years,” Dr Walker said.
“The goal is to get to no macroscopic residual disease, and the goal is to get to a CA-125 less than 10 after 3 cycles. Those are the patients that are going to live and have a good quality of life.”
Disclosures: Dr Walker reported having no conflicts of interest.
Read more of Cancer Therapy Advisor’s coverage of SGO 2022 by visiting the conference page.
Reference
Walker J, Mark B, Moore K, et al. Long term survival of GOG 252 “Randomized trial of intravenous versus intraperitoneal chemotherapy plus bevacizumab in advanced ovarian carcinoma: An NRG Oncology/GOG study.” Presented at SGO 2022; March 18-21, 2022. Abstract 21.
