1014 - Impact of chemotherapy beyond the third line in patients with recurrent epithelial ovarian cancer

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anti-Cancer Agents & Biologic Therapy
Ovarian Cancer
Presenter Laura Mansi
Authors L. Mansi1, E. Kalbacher1, M. Demarchi2, F. Bazan3, M. Schneider4, A. Vuillemin5, S. Bernhard6, V. Nerich7, C. Borg8, X. Pivot9
  • 1Doubs, oncology, 25000 - besancon/FR
  • 2Valencia, oncology, valencia/ES
  • 3Service Oncologie Medicale, oncology, besancon/FR
  • 4Nice, oncology, nice/FR
  • 5Medical Oncology, Hôpital Jean Minjoz, 25030 - Besançon/FR
  • 6University Hospital J. Minjoz, 25000 - Besancon/FR
  • 7Pharmacy, hopital Minjoz, 25000 - Besançon/FR
  • 8Medical Oncology, University Hospital Besançon, Besançon/FR
  • 9Medical Oncology, Hopital Minjoz, 25000 - Besançon/FR

Abstract

Objectives

The goal of this study was to determine the benefit in terms of time to disease control (TDC) achieved by the succession of chemotherapy lines beyond the third line in patients treated for recurrent epithelial ovarian cancer (EOC). Secondary objective were to identify patients who benefit from treatments beyond line three, and overall survival beyond the fourth line.

Methods

The cohort of patients was identified from a pharmacy database of cytotoxic chemotherapy administered between 1992 and 2010 at our regional center. Among 591 cases of EOC, a total of 122 patients were treated by more than 3 lines of chemotherapy. The evaluation of benefit obtained by each chemotherapy lines was based on TDC. Cox proportional hazards model was used to identify factors that could influence the TDC in each line of chemotherapy. Survival data was computed according to Kaplan-Meier method.

Results

Median OS was 53 months (95% CI, 47 to 67 months), and median OS after the third line was 15,3 months (95% CI, 12 to 20 months). Factors associated with longer OS after third line were performance status lower than 2 (p = 0.0058), no hepatic (p = 0.0098) and no pulmonary disease progression (p = 0.0003). Median durations of TDC was 4.15 (0 – 54.7), 4 (0 – 21.7), 3.34 (0 – 29.6), 4.97 (0 – 29.2), and 3.13 months (0 – 15), in fourth, fifth, sixth, seventh, eighth line, respectively. TDC was longer than 6 months in 34% to 40% of patients treated by line 4 to 8. The most important factor influencing TDC length in multivariate analysis beyond the third lines was the TDC duration obtained by the 2 previous lines of therapy (p = 0.03).

Conclusion

One can consider that those results might justify the administration of chemotherapy beyond the third line, in particular when the 2 previous lines are effective and let a disease control for more than six months.

Disclosure

All authors have declared no conflicts of interest.