An internationally-recognized gynecologic oncologist at St. Joseph's Hospital and Medical Center in Phoenix, Arizona is warning that the results from a long-awaited global study of ovarian cancer should be viewed cautiously.
Published in The Lancet last month, the study reported that women who received early chemotherapy for a recurrence of ovarian cancer did not live longer than those whose treatment is delayed.
"While this study is a bold challenge to the assumption of early treatment, there are several significant problems with the findings," says Bradley Monk, MD, and a leader in developing new approaches to cancer treatments. "Our focus should no longer be on standard chemotherapy, but on targeted genetics-based treatments."
Dr. Monk expressed his concerns about the ovarian cancer study in an editorial in The Lancet. He and Dr. Robert Morris, of Wayne State University, wrote that finding the relevant therapy is far more important than timing when treating ovarian cancer. "The most troubling problem with the trial is that contemporary therapies were not available to most of the participants," says Dr. Monk. "This lack of availability is related not only to the chronological length of the trial (which started in 1996), but also to regulatory and financial barriers restricting access to all active compounds in the participating countries."
In the study, survival rates were not significantly different between those who started chemotherapy once a higher concentration of cancer-related proteins were detected and those whose treatment was delayed until they had clinical symptoms.
A total of 1,442 women from 59 centers around the world registered for the trial, and 529 were randomly assigned to treatment groups. About 70 percent of the women died. Of the 370 deaths, 186 occurred in the early treatment group and 184 in the delayed treatment. Median survival was 25.7 months for those on early treatment and 27.1 months for those on delayed treatment.
- Robert T Morris, Bradley J Monk. Ovarian cancer: relevant therapy, not timing, is paramount. The Lancet, 2010; 376 (9747): 1120 DOI: 10.1016/S0140-6736(10)61515-2
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