Three-quarters of women treated for ovarian cancer face relapse of their disease. And while those who respond well to initial therapy do tend to survive longer, they require additional treatment for recurring cancer just as frequently as other women whose initial treatment response was not so pronounced. This is a key conclusion of new research from Roswell Park Cancer Institute (RPCI), published online ahead of print in the journal Gynecologic Oncology, that contributes new information about the dynamics of recurrent ovarian cancer.
Ovarian cancer remains the most lethal gynecologic cancer in the United States. Most women with the disease are initially treated with and respond well to platinum-based chemotherapy. However, as most patients are diagnosed at an advanced stage of disease, many will experience a relapse of their disease. They are likely to require multiple treatments of chemotherapy and to ultimately succumb to the disease. This study analyzed two time frames: the time from the start of chemotherapy to when the disease reoccurs and the time from the end of one chemotherapy regimen to the commencement of the next.
"The course of ovarian cancer has a common trajectory. This study offers a greater understanding of the factors that influence that trajectory and can help inform clinicians on the next best therapy to administer at the time of relapse," says Kevin Eng, PhD, lead author of the study and Assistant Professor of Oncology in the Department of Biostatistics and Bioinformatics at Roswell Park.
Roswell Park researchers conducted a retrospective survival analysis of 461 patients diagnosed with high-grade serous ovarian cancer who participated in The Cancer Genome Atlas. The researchers found that a complete response to initial therapy led to longer overall survival but did not impact treatment-free intervals after relapse of the disease. Additionally, the treatment-free interval steadily decreased for patients diagnosed with recurrent disease and treated with multiple rounds of chemotherapy. Evidence also suggests that platinum-based chemotherapies are superior therapies regardless of the patient's previous response to treatment.
"Our approach to the study of recurrent ovarian cancer is different from traditional research on the superiority and tolerability of different treatment regimens. Our approach is to study more than one or two serial recurrences of the disease, adding information about the response to therapy and natural progress of ovarian cancer," adds J. Brian Szender, MD, MS, senior author and a fellow in Gynecologic Oncology at RPCI.
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