Evaluating the impact of dose reductions and delays on progression-free survival in women with ovarian cancer treated with either three-weekly or dose-dense carboplatin and paclitaxel regimens in the national prospective OPAL cohort study.


Journal

Gynecologic oncology
ISSN: 1095-6859
Titre abrégé: Gynecol Oncol
Pays: United States
ID NLM: 0365304

Informations de publication

Date de publication:
07 2020
Historique:
received: 31 01 2020
accepted: 25 04 2020
pubmed: 10 5 2020
medline: 11 2 2021
entrez: 9 5 2020
Statut: ppublish

Résumé

To determine the impact of chemotherapy dose reductions and dose delays on progression-free survival (PFS) in women with ovarian cancer receiving first line chemotherapy in a real world prospective cohort study. Patients with newly diagnosed epithelial ovarian (or peritoneal, fallopian tube) cancer enrolled in a national Australian prospective study, OPAL, who commenced three-weekly carboplatin (AUC 5 or 6) and paclitaxel 175 mg/m 634 evaluable patients, 309 commenced CP and 325 DD-CP. Patient's age was similar in the two groups (median 62 years, range 21-79). All planned chemotherapy doses were completed by 66% vs 40% (p < 0.001) in the CP and DD-CP groups respectively. There was at least one treatment delay in 28% vs 58% (p < 0.001) in the CP and DD-CP groups, respectively, and 29% vs 49% (p < 0.001), respectively, required at least a 15% dose reduction for either carboplatin or paclitaxel. Median PFS was 29.2 [22.9, 43.8] and 21.5 [19.4, 23.1] months in the CP and DD-CP groups respectively. Adjusting for age, histology and FIGO stage PFS did not differ between treatment groups. Median PFS was similar in patients irrespective of dose reduction or dose delay. Patients receiving DD-CP required more dose reductions and delays due to haematological toxicities and lower completion rates than CP without significant difference in median PFS between CP and DD-CP. Median PFS was similar in patients irrespective of dose reduction or dose delay.

Identifiants

pubmed: 32381362
pii: S0090-8258(20)31016-7
doi: 10.1016/j.ygyno.2020.04.706
pii:
doi:

Substances chimiques

Carboplatin BG3F62OND5
Paclitaxel P88XT4IS4D

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

47-53

Informations de copyright

Crown Copyright © 2020. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest A deFazio has received research grant support from AstraZeneca Australia. P Webb has received research grant from National Health and Medical Research Council of Australia and AstraZeneca Australia. M Friedlander has received research grants from AstraZeneca Australia, personal fees from AstraZeneca, personal fees from MSD, personal fees from Takeda, personal fees from Lilly, other from AstraZeneca, other from Abbvie.

Auteurs

T Sivakumaran (T)

Peter MacCallum Cancer Centre, Melbourne, VIC, Australia. Electronic address: tharani.sivakumaran@petermac.org.

L Mileshkin (L)

Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia.

P Grant (P)

Gynaecological Oncology Unit, Mercy Hospital for Women, Melbourne, VIC, Australia.

L Na (L)

Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.

A DeFazio (A)

Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia; Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia.

M Friedlander (M)

Prince of Wales Clinical School, University of New South Wales, Department of Medical Oncology, Prince of Wales Hospital, Sydney, NSW, Australia.

A Obermair (A)

Queensland Centre for Gynaecological Cancer Research, University of Queensland, Centre for Clinical Research, RBWH, Herston, QLD, Australia.

P M Webb (PM)

QIMR Berghofer Medial Research Institute, Brisbane, QLD, Australia.

G Au-Yeung (G)

Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia.
QIMR Berghofer Medial Research Institute, Brisbane, QLD, Australia.

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Classifications MeSH