New Trial Suggests Maintenance Chemotherapy Does Not Aid Overall Survival

Results from a randomized trial suggest maintenance chemotherapy after debulking surgery and adjuvant platinum-based chemotherapy do not improve overall survival rates among women with ovarian cancer who had achieved remission.
Maintenance chemotherapy after debulking surgery and adjuvant platinum-based chemotherapy did not improve overall survival (OS) rates in women with ovarian cancer who had achieved complete remission, according to results from a randomized trial presented at the 2017 Society of Gynecologic Oncology Annual Meeting.

After a median follow-up of almost six years, patients treated with conventional paclitaxel and a paclitaxel conjugate had a median OS of 51 and 60 months, respectively, compared with 55 months for patients assigned to surveillance with standard follow-up care.

The trial did show a modest improvement in progression-free survival (PFS) with either of the taxane-based maintenance therapies, Larry Copeland, M.D., a medical oncologist at The Ohio State University.

“The trial was designed to give us a definitive answer, which is why we chose OS as the primary endpoint,” Copeland said. “As often occurs in the trials we do, the PFS was positive, but the OS did not show a benefit. In addition, the additional therapy was not without some toxicity that we consider significant.”

The trial design addressed a common problem in the management of ovarian cancer. Upfront surgery and chemotherapy leads to a clinical complete response (CCR) for many patients, but a substantial proportion of patients who achieve a CCR eventually have recurrent disease, which often proves fatal.

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