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QOL a Factor in Combo vs. Sequential Tx for Ovarian Ca


 

Major Finding: Median progression-free survival reached 13.7 months for women treated with combination docetaxel and carboplatin therapy, vs. 8.4 months for those treated with sequential therapy.

Data Source: A randomized trial of 150 women with recurrent platinum-sensitive ovarian cancer.

Disclosures: Dr. Alvarez-Secord has received grants and research support from or served as a consultant to several pharmaceutical companies and device manufacturers, including GlaxoSmithKline, Eli Lilly & Co., Sanofi-Aventis, Precision Therapeutics Inc., and Intuitive Surgical Inc.

SAN FRANCISCO — Combination docetaxel and carboplatin therapy significantly improved progression-free survival among women with recurrent platinum-sensitive ovarian cancer, compared with sequential therapy, in a randomized trial of 150 patients.

The improvement was associated with higher neurotoxicity, however, and quality of life studies are ongoing, Dr. Angeles Alvarez-Secord of Duke University in Durham, N.C., said at the annual meeting of the Society of Gynecologic Oncologists.

Combination therapy with docetaxel and carboplatin has been shown to improve survival in platinum-sensitive ovarian cancer patients, but it had not been compared with sequential therapy regarding efficacy and adverse events, Dr. Alvarez-Secord said.

In this multicenter, phase II study, median progression-free survival (the primary end point) reached 13.7 months for women who were treated with combination therapy, vs. 8.4 months for those who received the same drugs in sequence.

Median overall survival was similar at 33 months and 30 months.

After clinical variables were controlled for, women who were treated with sequential therapy had a 62% increased risk of disease progression, compared with those who received combination therapy.

The study population included women with platinum-sensitive peritoneal, ovarian, or tubal cancer who were enrolled between January 2004 and March 2009.

Their average age was 64 years; demographic characteristics were similar between the two groups.

One group of 75 women received 30 mg/m

The overall response rates for the combination and sequential therapies were 55% and 43%.

The incidence of grade 2 or 3 neurotoxicity was higher in the combination therapy group (11.7% vs. 8.5%), as was the incidence of grade 3 or 4 neutropenia (36.8% vs. 11.3%).

“I was very surprised to see that the quality of life was superior for those patients that were treated with sequential monotherapy, compared with combination therapy,” Dr. Alvarez-Secord said in an interview.

The clinical implication of the study is that combination therapy, although yielding a survival benefit, was associated with a worse quality of life, she said.

“It becomes a counseling issue,” she continued.

The results contribute to the larger goal of being able to customize cancer care to a patient's preferences and priorities, rather than taking a one-size-fits-all approach, Dr. Alvarez-Secord said.

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