HMT Improves PFS in Serous Carcinoma of the Ovary, Peritoneum

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Hormone maintenance therapy produced better PFS than observation for stage II-IV low-grade serous carcinoma of the ovary.
Hormone maintenance therapy produced better PFS than observation for stage II-IV low-grade serous carcinoma of the ovary.

Women with stage II-IV low-grade serous carcinoma of the ovary or peritoneum who took hormone maintenance therapy (HMT) after primary therapy experienced significantly longer progression-free survival (PFS) than did women who underwent routine observation. These results indicate the need for a prospective trial.1

This study examined outcomes correlated with HMT vs routine observation after primary cytoreductive surgery and platinum-based chemotherapy in women with stage II-IV low-grade serous carcinoma.

“On the basis of our clinical experience, LGSC [low-grade serous carcinoma] does not seem to be completely resistant to platinum-based chemotherapy,” wrote the researchers.

“Furthermore, in the absence of prospective data indicating otherwise, we continue to recommend platinum plus taxane chemotherapy to women with newly diagnosed stage II to IV LGSC after primary cytoreductive surgery.”

Researchers examined data from patients with stage II-IV low-grade serous carcinoma who were treated with primary surgery followed by platinunum-based chemotherapy and had at least 2 years of follow-up with no recurrence of disease and had sufficient clinical information.

The researchers compared progression-free survival and overall survival (OS) in women who underwent HMT and women who underwent standard observation. Researchers additionally performed subset analyses for patients who were free of disease or had persistent disease.

From 1982 to 2013, 203 eligible patients were seen at University of Texas MD Anderson Cancer Center, Houston, Texas. Of these, 70 received HMT and 133 underwent standard observation.

In patients who received HMT, median PFS was 64.9 months vs 26.4 months in the standard observation group (P <.001). Overall survival was 115.7 months in the HMT group and 102.7 months in the standard observation group; these results were not statistically different from each other.

In women who were disease-free, median PFS was greater for those who received HMT (81.1 vs 30.0 months; P <.001). PFS was also longer for women with persistent disease who received HMT (38.1 vs 15.2 months; P <.001).

Women who received HMT had a significantly smaller risk of progressed disease compared with women who underwent standard observation (hazard ratio, 0.44; 95% CI, 0.31 to 0.64; P <.001).

Reference

1. Gershenson DM, Bodurka DC, Coleman RL, Lu KH, Malpica A, Sun CC. Hormonal maintenance therapy for women with low-grade serous cancer of the ovary or peritoneum. J Clin Oncol. 2017 Feb 21. doi: 10.1200/JCO.2016.71.0632. [Epub ahead of print]

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