MONITOR VII: Treatment strategies of low grade ovarian carcinomas – A German survey of the Charité – Berlin and Kliniken Essen Mitte with support of the study groups NOGGO and AGO

Alavi, Seyed Ali; Harter, P; Richter, Rolf; Keller, Maren; Oskay-Özcelik, Gülten; Mustea, Alexander; Schmalfeldt, Barbara; Wimberger, Pauline; Trillsch, Fabian; Mahner, S; Klar, Maximilian; Wagner, Uwe; Chekerov, Radoslav; Bois, Andreas du; Sehouli, Jalid

doi:10.1093/annonc/mdy285.202

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“…Still, solid data from prospective randomized clinical trials of antihormonal treatment versus cytotoxic chemotherapy are lacking and broad national and international variations in practice exist regarding their clinical utilization. For example, in a German survey, 43% of physicians (gynecologists, gynecologic oncologists, and oncologists) did not consider antihormonal therapy as a treatment option [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Traditional Systemic Treatment Options in Advanced Low-Grade Serous Ovarian Cancer after Successful Cytoreduction: A Systematic Review and Meta-Analysis

Montero-Macías¹,

Rigolet

Mikhael³

et al. 2022

Cancers

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Objective: We performed a systematic literature review and a subsequent meta-analysis to compare traditional treatment options, i.e., antihormonal and cytotoxic, in LGSOC. Methods: We conducted a systematic literature review in MEDBASE and MEDLINE between September 2000 and June 2021 for women who received cytotoxic chemotherapy and/or antihormonal treatment after primary cytoreduction due to stage II–IV LGSOC and also at relapse. PFS and OS were calculated depending on the type of their adjuvant treatment. For each endpoint in the meta-analysis, pooled HR was calculated using the random effect model with the inverse variance weighted method. Only primary patients were included in the subsequent meta-analysis due to the small number of studies in the relapsed setting. Results: Five eligible first-line studies were included. Systemic chemotherapy failed to provide a significant OS benefit when compared to no systemic treatment (pooled HR = 1.01, 95% CI [0.79, 1.29]) after successful cytoreduction. Moreover, systemic chemotherapy followed by antihormonal treatment also did not result to a significant PFS or OS benefit when compared to systemic chemotherapy alone (for PSF: pooled HR = 0.59, 95% CI [0.33, 1.04]; for OS: pooled HR = 0.83, 95% CI [0.50, 1.39]). There were insufficient data from studies in the recurrent setting to allow their inclusion in the meta-analysis. Conclusions: In this meta-analysis, we failed to identify a traditional cytotoxic or antihormonal systemic treatment option that was associated with a significant OS or PFS benefit when administered following successful cytoreduction for advanced LGSOC. Prospective randomized studies are urgently warranted to define optimal adjuvant options in this challenging disease.

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Section: Discussionmentioning

confidence: 99%