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Poster display session

2982 - ICON7: ovarian cancer, platinum second-line chemotherapy and overall survival

Date

09 Sep 2017

Session

Poster display session

Presenters

Adrian Cook

Citation

Annals of Oncology (2017) 28 (suppl_5): v330-v354. 10.1093/annonc/mdx372

Authors

A. Cook1, A. Embleton1, G. Jayson2, R. Kaplan1, G. Kristensen3, M.K. Parmar1, J. Pfisterer4, E. Pujade-Lauraine5, A.M. Oza6, T. Perren7

Author affiliations

  • 1 Mrc Clinical Trials Unit, Institute of Clinical Trials and Methodology-UCL, WC2B6NH - London/GB
  • 2 Division Of Molecular & Clinical Cancer Sciences, The Christie NHS Foundation Trust, M20 4BX - Manchester/GB
  • 3 Department For Gynecologic Oncology And Institute For Cancer Genetics And Informatics, NSGO and Oslo University Hospital, Oslo/NO
  • 4 Gynecologic Oncology Center, Womens Cancer Center, 24103 - Kiel/DE
  • 5 Centre Des Cancers De La Femme  , AP-HP, Hôpitaux Universitaires Paris Centre site Hôtel-Dieu, Paris/FR
  • 6 Division Of Medical Oncology And Hematology, Princess Margaret Cancer Centre, M5G 1Z5 - Toronto/CA
  • 7 Leeds Institute Of Cancer And Pathology, St. James's University Hospital Leeds, LS9 7TF - Leeds/GB
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Resources

Abstract 2982

Background

The ICON7 trial reported increased progression-free survival with bevacizumab (bev) added to platinum-based chemotherapy in newly-diagnosed ovarian cancer, and increased overall survival (OS) in a poor prognosis subset. Most patients (pts) had further chemotherapy following progression. On average, pts receiving bev had later progression and were thus more likely to receive further platinum. We investigated the effect of second-line treatment type on the association between first-line bev and OS.

Methods

Second line chemotherapy regimens were categorised as platinum-containing or other. Platinum reuse varied with time to progression after end of 1st line (excl. maintenance bev) and also varied between centres. We categorised centres as high or low platinum use, from the proportion of their pts progressing in 0-8 months (mths) and retreated with platinum. The association between 1st line bev and OS was analysed separately at low-use centres and at high-use centres. Standard survival analysis techniques and methods appropriate for data with non-proportional hazards were used.

Results

ICON7 randomised 1528 pts 1:1 to reference treatment +/- bev. Reference pts were more likely to experience disease progression ≤8 mths (38% v 24%). Reuse of platinum varied with time to progression; 37% at 0-5 mths; 76% at 6-8 mths; 94% at ≥ 9 mths. 174 centres (covering 1290 pts) had ≥1 progression at 0-8 mths, 76 centres were classed low-use (

Conclusions

Improved OS with bevacizumab may result from an association with platinum-containing second line treatment: bev increases time to progression, increased time to progression increases the likelihood of second line platinum, second line platinum increases OS. It is possible therefore that OS might be improved by a lower time threshold for second line platinum chemotherapy, whether or not bevacizumab has been used.

Clinical trial identification

ISRCTN: 91273375

Legal entity responsible for the study

ICON7 was a GCIG trial, overall sponsor is Medical Research Council, UK.

Funding

Medical Research Council Clinical Trials Unit at University College London

Disclosure

All authors have declared no conflicts of interest.

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