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 Cytotoxic agents
Ovarian Cancer
Therapy
Biological therapy
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.