982P - Platinum combination chemotherapy versus platinum monotherapy in platinum-sensitive recurrent ovarian cancer: a meta-analysis of randomised trials u...

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Anti-Cancer Agents & Biologic Therapy
Ovarian Cancer
Presenter Fharat Raja
Authors F.A. Raja1, N. Counsell2, N. Colombo3, M.K. Parmar4, J. Pfisterer5, I.B. Vergote6, A. Gonzalez Martin7, D. Alberts8, M. Plante9, J.A. Ledermann10
  • 1UCL, W1T4TJ - London/UK
  • 2Cancer Research Uk & Ucl Cancer Trials Centre, UCL, W1T4TJ - London/UK
  • 3European Institute of Oncology, 20141 - Milan/IT
  • 4Medical Research Council (MRC)MRC Clinical Trials Unit, GB-NW1 2DA - London/UK
  • 5St, DE-42653 - Solingen/DE
  • 6Obstetrics & Gynaecology, University Hospital Gasthuisberg, BE-3000 - Leuven/BE
  • 7Servicio De Oncologia Medica, MD Anderson Cancer CenterCenter Espana, ES-28033 - Madrid/ES
  • 8Oncology, The University of Arizona Cancer Center, 85724-5024 - Arizona/US
  • 9Gynecologic Oncology Service, Centre Hospitalier Universitaire De Québec (chuq), L'hôtel-dieu De Québec,, Laval University, Quebec/CA
  • 10Cancer Research Uk And Ucl Cancer Trials Centre, UCL, W1T4TJ - London/UK

Abstract

Objectives

The majority of women with ovarian cancer develop recurrent disease. For patients with a platinum free interval of > 6months, platinum based chemotherapy is the treatment of choice. The benefit of platinum-based combination chemotherapy in randomised trials varies and a meta-analysis was performed to gain more secure information on the size of the benefit of this treatment.

Methods

we initiated a systematic review to determine whether combination chemotherapy is superior to single agent platinum chemotherapy in women with relapsed platinum-sensitive ovarian cancer. The systematic review and meta-analysis followed a pre-specified protocol.

Results

A total of five potentially eligible trials that had used combination platinum chemotherapy versus single agent platinum chemotherapy in women with relapsed platinum-sensitive ovarian cancer were identified. For one trial adequate contact with the investigators could not be established. Therefore, four trials that randomly assigned 1,300 (87%) patients were included, with a median follow-up of 36.1 months. OS analyses were based on 865 deaths and demonstrated a statistically significant benefit of combination platinum chemotherapy on survival (HR, 0.80; 95% CI, 0.64 to 1.00; p = .050). PFS analyses were based on 1,167 events and demonstrated a highly statistically significant benefit of combination platinum chemotherapy on progression-free survival (HR, 0.68; 95% CI, 0.57 to 0.81; p < .00001). There was no evidence of a difference in the relative effect of combination platinum chemotherapy on either OS or PFS in patient subgroups defined by previous paclitaxel treatment, duration of treatment-free interval, or the number of previous lines of chemotherapy.

Conclusions

In this IPD meta-analysis we have demonstrated that combination-platinum chemotherapy significantly improves overall survival and progression-free survival across all subgroups. This provides the strongest evidence to date of the benefit of combination-platinum over single agent platinum.

Disclosure

J.A. Ledermann: Jonathan Ledermann has acted in an advisory role to Boehringer Ingelheim, Janssen and Roche. All other authors have declared no conflicts of interest.