Continued chemotherapy after complete response to primary therapy among women with advanced ovarian cancer

Lisa M. Hess, Nan Rong, Patrick Monahan, Paridha Gupta, Champ Thomaskutty, Daniela Matei

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

BACKGROUND. Ovarian cancer (OC) is associated with a >75% risk of recurrence after completion of primary therapy. Several clinical trials have explored the role of continued therapy after complete response to primary adjuvant therapy to reduce the risk of recurrence; however, these trials have largely been underpowered, leading to inconclusive results. METHODS. A systematic search strategy was initiated to identify all clinical trials involving consolidation or maintenance therapy regimens for OC in first complete remission. A meta-analysis was conducted to evaluate toxicity and progression-free (PFS) and overall survival (OS). RESULTS. There were 37 publications meeting all eligibility criteria, representing 20 consolidation and 9 maintenance therapy trials. Consolidation and maintenance therapies were associated with improved PFS (hazard ratio [HR], 0.79 [P =.003] and HR, 0.82 [P =.02], respectively) and OS (HR, 0.68 [P =.0008] and HR, 0.68 [P =.007], respectively). This relationship remained statistically significant when the analysis was limited to randomized trials and across other sensitivity analyses. CONCLUSIONS. Although individual studies have not yet convincingly shown a survival advantage with maintenance chemotherapy in OC, this meta-analysis demonstrates that continued chemotherapy after completion of primary therapy for OC improves PFS and OS. Benefits are greatest in patients with advanced stage OC who reach complete clinical or pathologic response after primary therapy.

Original languageEnglish
Pages (from-to)5251-5260
Number of pages10
JournalCancer
Volume116
Issue number22
DOIs
StatePublished - Nov 15 2010

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Ovarian Neoplasms
Drug Therapy
Survival
Therapeutics
Meta-Analysis
Maintenance Chemotherapy
Clinical Trials
Recurrence
Publications

Keywords

  • chemotherapy
  • consolidation
  • maintenance
  • meta-analysis
  • ovarian cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Continued chemotherapy after complete response to primary therapy among women with advanced ovarian cancer. / Hess, Lisa M.; Rong, Nan; Monahan, Patrick; Gupta, Paridha; Thomaskutty, Champ; Matei, Daniela.

In: Cancer, Vol. 116, No. 22, 15.11.2010, p. 5251-5260.

Research output: Contribution to journalArticle

Hess, Lisa M. ; Rong, Nan ; Monahan, Patrick ; Gupta, Paridha ; Thomaskutty, Champ ; Matei, Daniela. / Continued chemotherapy after complete response to primary therapy among women with advanced ovarian cancer. In: Cancer. 2010 ; Vol. 116, No. 22. pp. 5251-5260.
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