Abstract 535P
Background
Treatments (ttt) of non-epithelial rare germ cell tumors (GCT) and sex cord stromal tumors (SCST) are associated with long survival. The standard treatment mainly includes conservative surgery combined with chemotherapy (CT) [bleomycin, etoposide and cisplatin (BEP)] depending on stage and prognostic factors. As reported in testicular cancer survivors, BEP may induce late side effects with negative impact on quality of life (QOL). The French Rare Malignant Gynecological Tumors (TMRG)/GINECO case-control VIVROVAIRE Rare tumors study assessed long term QOL among survivors treated with BEP as compared to age-matched healthy women (HW).
Methods
Non-epithelial ovarian cancer survivors (nEOCS), cancer-free ≥2 years after end of treatment, were identified from the INCa French Network for TMRG. HW were issued from the ‘Seintinelles’ research platform. QOL (FACT-G and FACT-O), chronic fatigue (MFI), anxiety/depression (HADS), insomnia (ISI), neurotoxicity (FACT/GOG-NTX), cognition (FACT-COG) and sexuality items (from the FACT-O OCS) were compared between nEOCS and HW. A minimal 5% difference for the score between groups was considered as clinically relevant.
Results
144 nEOCS were included with 144 age-matched HW (mean age at inclusion: 38 yrs; 60% aged below 40). Most nEOCS were treated for GCT (n=112). Median delay from the end of ttt to inclusion was 6 yrs. At inclusion, 42% of nEOCS were menopausal versus 17% of HW (p<0.001). General and ovarian QOL, fatigue, anxiety/depression and insomnia scores were similar between nEOCS and HW. nEOCS reported clinically significant (6%) better social functioning (p=0.006). However, nEOCS reported more perceived cognitive impairment than HW (31 vs 14%, p<0.001) and clinically significant (8%) neurotoxicity (p<0.001). In addition, nEOCS reported less interest in sex (35% vs 55%, p<0.001), felt less like a woman (67% vs 81%, p=0.012), and were more afraid of not having children (31% vs 13%, p=0.007) than HW, whatever the menopausal status.
Conclusions
6 yrs after BEP CT, most of nEOCS reported similar global QOL as HW, but experienced more risk of premature menopause, some late side effects on cognition, neurotoxicity and sexuality that may impact their daily life.
Clinical trial identification
NCT03418844, N° ID-RCB: 2017-A03028-45.
Editorial acknowledgement
Legal entity responsible for the study
Centre François Baclesse & ARCAGY – GINECO.
Funding
This work was supported by the ARC Foundation for Cancer Research and the IMAGYN association.
Disclosure
F. Joly Lobbedez: Financial Interests, Personal, Advisory Board: GSK, AstraZeneca, MSD, Janssen, ipsen, BMS, Bayer, Esai; Financial Interests, Personal, Invited Speaker: GSK, AstraZeneca, MSD, Janssen, Ipsen, Amgen, Astellas; Financial Interests, Institutional, Invited Speaker: GSK, AstraZeneca; Financial Interests, Institutional, Research Grant: BMS; Other, travel: MSD, GSK. I.L. Ray-Coquard: Financial Interests, Personal, Advisory Board: Roche, GSK, AstraZeneca, Mersana, Deciphera, Amgen, Oxnea, Merck Sereno, Agenus, Novartis, Macrogenics, Clovis, EQRX, Adaptimmune, Eisai, SUTRO; Financial Interests, Institutional, Other, COLIBRI translational research: BMS; Financial Interests, Institutional, Advisory Board, translational research NEOPREMBROV trial: MSD; Non-Financial Interests, Principal Investigator: PAOLA1; Non-Financial Interests, Other, President: GINECO. A. Floquet: Financial Interests, Personal, Other, Consultancy: GSK; Financial Interests, Institutional, Invited Speaker: AstraZeneca, Clovis Oncology; Financial Interests, Invited Speaker, French coordinator - DUO TRIAL: AstraZeneca; Financial Interests, Invited Speaker, French coordinator- MIRASOL TRIAL: ImmunoGen. F. Selle: Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Other: AstraZeneca, Tesaro, Clovis, MSD, PharmaMar, GlaxoSmithKline. S. Frank: Non-Financial Interests, Personal, Invited Speaker: GSK, Pfizer, Novartis, Lilly. T. De La Motte Rouge: Financial Interests, Personal, Advisory Board: Pfizer, AstraZeneca, GSK, Clovis Oncology, Roche, Mylan, Tesaro; Financial Interests, Institutional, Advisory Board: MSD; Financial Interests, Institutional, Research Grant: Novartis, Pfizer, Msd, Seagen; Financial Interests, Institutional, Invited Speaker: Roche, AstraZeneca, GSK, MSD, Pfizer, Netris Pharma; Non-Financial Interests, Advisory Role: French National Cancer Institute, Unicancer; Non-Financial Interests, Principal Investigator: ARCAGY. J. Alexandre: Financial Interests, Personal, Advisory Board: AstraZeneca, Pfizer. P. Augereau: Financial Interests, Personal, Advisory Board: AstraZeneca, Pfizer. C. Nadeau: Non-Financial Interests, Personal, Invited Speaker: GSK. P. Pautier: Financial Interests, Personal, Advisory Board, 2015, 2022: PharmaMar; Financial Interests, Institutional, Advisory Board, 2020: Roche, Clovis; Financial Interests, Institutional, Advisory Board, 2021: AstraZeneca; Financial Interests, Personal, Advisory Board, 2019-2020: AstraZeneca; Financial Interests, Institutional, Advisory Board: GSK; Financial Interests, Personal, Advisory Board, 2018-2019: Roche; Financial Interests, Institutional, Expert Testimony, 2022: MSD. All other authors have declared no conflicts of interest.