Investigators have found that patients with platinum-resistant epithelial ovarian cancer who participate in clinical trials may have higher rates of overall survival compared with those who don’t participate in clinical trials, according to findings presented by Morton et al at the Society of Gynecologic Oncology (SGO) 2023 Annual Meeting on Women’s Cancer.
Background
“Effective treatment options for platinum-resistant [epithelial] ovarian cancer are limited, and our data underscores the importance of clinical trial access for all patients with this condition to improve patient outcomes,” emphasized Molly Morton, MD, a gynecology oncology fellow at The Ohio State University Comprehensive Cancer Center–James Cancer Hospital and Solove Research Institute. “Better understanding of the benefits of clinical trial participation may lead to improved counseling and enrollment, and further study of individual provider and patient barriers to engagement with clinical trials is critical to advancing patient care,” she added.
Study Methods and Results
In the new retrospective, single-institution cohort study, the investigators divided 305 patients with epithelial ovarian cancer into two cohorts: 46 patients who participated in clinical trials and 259 participants receiving standard-of-care therapy.
Among the patients in both groups, there were no significant differences in age, body mass index, race, comorbidities, and Eastern Cooperative Oncology Group performance status. There were also no differences in the use of poly (ADP-ribose) polymerase (PARP) inhibitors, bevacizumab, or intraperitoneal chemotherapy. However, those who participated in clinical trials were exposed to a greater number of therapy lines compared with those receiving standard-of-care therapy.
After conducting their analysis, the investigators discovered that the patients involved in clinical trials were associated with a median overall survival of 13.8 months compared with 10.5 months among patients receiving standard-of-care therapy—underscoring the importance of making clinical trials more broadly available in the gynecologic cancer space.
As availability and participation in clinical trials in the gynecologic cancer care space increases, researchers must be mindful of current racial disparities and work to ensure that research funding allocations address them.
In a separate study, investigators examined National Cancer Institute funding allocations from 2011 to 2018 for differences in lethality by race for gynecologic cancers—including breast cancer, endometrial cancer, ovarian cancer, and cervical cancer. The investigators found that the funding-to-lethality score was lowest for Black patients with endometrial cancer, whereas the funding-to-lethality score was highest for White patients with breast cancer.
Conclusions
“Research is an important tool to ameliorate disparities,” highlighted Linda Zambrano Guevera, MS, an MD candidate at the Duke University School of Medicine and a medical assistant at Hampton Pediatrics. “Gynecologic cancers are significantly underfunded compared to other types of malignancies, which is particularly alarming given [the] stark disparities. SGO and other stakeholders have put energy and resources into lobbying [for] research funding agencies to ensure more equitable access to research [for] underfunded cancers, and must continue to do so to improve clinical outcomes for gynecologic cancer patients,” she concluded.
