Abstract 19P
Background
Non-epithelial rare germ cell tumors (GCT) and sex cord stromal tumors (SCST) are mainly associated with long survival. The treatment includes surgery, frequently combined with chemotherapy (CT). The French Rare Malignant Gynecological Tumors (TMRG)/GINECO case-control VIVROVAIRE Rare tumors study already reported the QOL among survivors, treated with surgery +CT, compared to age-matched healthy women (HW). Looking to the different clinical profile of pts, we intend to describe the long-term fatigue according to subtype of cancers (SCST, GCT).
Methods
Non-epithelial ovarian cancer survivors (nEOCS), cancer-free ≥2 years after treatment, were identified from the TMRG Network. HW were issued from the ‘Seintinelles’ research platform. Primary endpoint was chronic fatigue (MFI) compared between patients (SCST/GCT) versus HW. A minimal 5% difference for the score between groups was considered as clinically relevant.
Results
97 SCST and 120 GCT were included. Patients' characteristics are detailed in the table. SCST patients were older than GCT and mostly FIGO stage I. Median delay from the end of treatment was 6 yrs. In univariate analysis, among SCST treated with CT, levels of general fatigue were significantly higher compared with HW (MFI general fatigue median score 27.0 [IQR: 21.0-31.0] vs 23.0 [17.3-27.8], p= 0.02). Among GCT treated with CT, fatigue was not different from HW (MFI general fatigue median score 24.0 [20.0-29.0] vs 23.0 [18.0-30.0], p= 0.592). After adjustment on age, schooling, BMI, insomnia and physical activity (IPAQ), fatigue remained significantly higher for all SCST, compared with all HW (beta= 1.67; p = 0.026); but not for SCST compared with age-matched HW (p=0.098).
Table: 19P
Patients’ characteristics and levels of fatigue
| SCST | SCST treated with CT | Age-matched HW | GCT | GCT treatedwith CT | Age-matched HW | |
| Number of patients | 97 | 45 | 86 | 120 | 99 | 198 |
| Median age (yrs) | 58 | 49 | 50 | 32 | 33 | 33 |
| FIGO | ||||||
| stage I | 73 (75%) | 24 (53%) | 60 (50%) | 40 (40%) | ||
| stage II | 4 (4%) | 4 (9%) | 8 (7%) | 8 (8%) | ||
| stage III | 10 (10%) | 9 (20%) | 30 (25%) | 30 (30%) | ||
| NA | 10 (10%) | 8 (18%) | 22 (18%) | 21 (21%) | ||
| MFI general fatigue median score | 27.0 [21.0-31.0] | 23.0 [17.3-27.8] p= 0.02 | 24.0 [20.0-29.0] | 23.0 [18.0-30.0] p= 0.592 |
Conclusions
SCST patients (older pts compared to GCT) have long-term fatigue more than 6yrs after the end of treatments, which was not observed for GCT patients. This long-term fatigue need to be integrated in the follow-up care plan of nEOCS.
Clinical trial identification
NCT03418844.
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
ARC Foundation for Cancer Research and the IMAGYN association.
Disclosure
C. Dubot: Financial Interests, Institutional, Invited Speaker: MSD, Amgen; Non-Financial Interests, Personal, Principal Investigator: AstraZeneca; MSD; GSK. I.L. Ray-Coquard: Financial Interests, Institutional, Research Grant: MSD, Roche, BMS; Financial Interests, Personal, Invited Speaker: Agenus, Advaxis, BMS, PharmaMar, Genmab, Pfizer, AstraZeneca, Merck; Financial Interests, Personal, Advisory Board: AbbVie, Agenus, Advaxis, BMS, PharmaMar, Genmab, Pfizer, AstraZeneca, Roche/Genentech, GSK, MSD, Deciphera, Mersena, Merck Sereno, Novartis, Amgen, Tesaro and Clovis; Springworks, Adaptimmune, Immunogen, Seagen, Novocure, Daiichi Sankyo, Travel support fro. 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; Financial Interests, Personal and Institutional, Research Grant: PharmaMar; Financial Interests, Personal, Research Grant: Onxeo. F. Selle: Financial Interests, Personal, Invited Speaker: AstraZeneca, MSD, GSK/Tesaro, Eisai; Financial Interests, Personal, Advisory Board: AstraZeneca, MSD, GSK/Tesaro. T. De La Motte Rouge: Financial Interests, Personal, Advisory Board: Pfizer, AstraZeneca, GSK, Clovis Oncology, Roche, MSD, Mylan, Tesaro, Gilead, Sanofi, Seagen; Financial Interests, Personal, Invited Speaker: Novartis, 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, Personal, Advisory Role: French National Cancer Institute, Unicancer; Non-Financial Interests, Personal, Principal Investigator: Arcagy, Unicancer; Non-Financial Interests, Personal, Other, Co-Principal Investigator: Unicancer; Non-Financial Interests, Personal, Other, partnership using a Natera solution for a clinical trial funded by academic grant: Natera. J. Alexandre: Financial Interests, Personal, Advisory Board: Eisai, MSD, GSK, Janssen, Pfizer; Financial Interests, Personal, Invited Speaker: Eisai, MSD, AstraZeneca, GSK, Novartis; Financial Interests, Institutional, Research Grant: Janssen, GSK, MSD; Financial Interests, Institutional, Invited Speaker: MSD, Eisai, Agenus, GSK, Immunogen, Incyte. P. Augereau: Financial Interests, Personal, Invited Speaker: AstraZeneca, Daiichi Sankyo, Novartis, MSD, GSK. J.E. Kurtz: Financial Interests, Personal, Advisory Board: AstraZeneca, Eisai, GSK, MSD, Roche, PharmaMar; Financial Interests, Personal, Invited Speaker: Chugai, Clovis, Dragonfly, Tesaro; Financial Interests, Personal, Principal Investigator: Mersana. F. Joly Lobbedez: Financial Interests, Personal, Invited Speaker: Amgen, Eisai, Janssen; Financial Interests, Personal, Advisory Board: AstraZeneca, Astellas, Bayer, GSK, Ipsen, MSD, Novartis, Pfizer, Seagen; Financial Interests, Institutional, Invited Speaker: Viatris; Other, Personal, Research Grant: BMS. All other authors have declared no conflicts of interest.