Adjuvant Hormone Therapy May Improve Survival in Epithelial Ovarian Cancer
Results of the phase III AHT trial reported in the Journal of Clinical Oncology by Eeles et al suggest that adjuvant hormonal therapy may improve survival in women with epithelial ovarian cancer. The trial, started in 1990, was stopped early due to low recruitment.
Study Details
In the open-label trial, 150 premenopausal or postmenopausal women diagnosed with epithelial ovarian cancer within the prior 9 months from 19 sites in the UK, Spain (one site), or Hungary (one site) were randomly assigned between 1990 and 1995 to receive adjuvant hormone therapy (n = 75) or no hormone therapy (n = 75) for 5 years.
Survival Outcomes
Median follow-up in surviving patients was 19.1 years at last analysis. Death occurred in 71% of the hormone therapy group vs 91% of the control group (hazard ratio [HR] = 0.63, P = .011). The difference remained significant after adjustment for known prognostic factors (HR = 0.51, 95% confidence interval [CI] = 0.34–0.76). Relapse-free survival events occurred in 72% vs 91% of patients (HR = 0.67, P = .032).
The investigators noted: “Despite the fact that this trial terminated accrual early because of challenges in recruitment, it remains, to our knowledge, the largest random assignment trial to investigate whether [adjuvant hormone therapy] has an adverse (or beneficial) effect on survival after ovarian cancer treatment.”
They concluded: “These results show that women who have severe menopausal symptoms after ovarian cancer treatment can safely take hormone-replacement therapy, and this may, in fact, infer benefits in terms of [overall survival] in addition to known advantages in terms of quality of life.”
Rosalind Eeles, FMedSci, PhD, of The Institute of Cancer Research, Surrey, is the corresponding author for the Journal of Clinical Oncology article.
The study was supported by The Institute of Cancer Research, Cancer Research UK, and National Institute for Health Research. For full disclosures of the study authors, visit jco.ascopubs.org.
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