In a single-institution experience reported in the Journal of Clinical Oncology, Gershenson et al at MD Anderson Cancer Center found that hormonal maintenance therapy was associated with improved progression-free survival among women with stage II to IV low-grade serous carcinoma of the ovary or peritoneum who had received primary cytoreductive surgery and platinum-based chemotherapy.
The study involved 203 patients treated between 1981 and 2013 who had at least 2 years of follow-up if they had not had recurrence of disease. Of them, 70 received hormone maintenance treatment, and 133 underwent observation.
Among all patients, median progression-free survival was 64.9 months in the hormonal therapy group vs 26.4 months in the observation group (P < .001); on multivariate analysis (including the year of diagnosis, age, group, stage, and site), the hazard ratio (HR) was 0.44 (P < .001). Median overall survival was 115.7 vs 102 months (univariate HR = 0.84, P = .42).
Median progression-free survival was 81.1 vs 30.0 months among women who were clinically disease free at the end of chemotherapy and 38.1 vs 15.2 months among those with persistent disease at the end of chemotherapy (P < .001 on stratified log-rank test adjusted for disease status). Median overall survival was 191.3 vs 106.8 months among women disease free at the end of chemotherapy and 88.3 vs 44.4 months among those with persistent disease (P = .014 on stratified log-rank test adjusted for disease status).
The investigators concluded: “Women with stage II to IV low-grade serous carcinoma who received [hormonal maintenance therapy] after primary treatment had significantly longer [progression-free survival] compared with women who underwent [observation]. These findings warrant further investigation using a prospective trial design.”
The study was supported by the Sara Brown Musselman Fund for Serous Ovarian Cancer Research and a grant from the National Cancer Institute.
David M. Gershenson, MD, of The University of Texas MD Anderson Cancer Center, is the corresponding author of the Journal of Clinical Oncology article.
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