title: Consolidation strategies in ovarian cancer: observations for future clinical trials.
abstract: PURPOSE.: To describe the characteristics of a series of study populations of ovarian cancer patients with identical eligibility criteria in second or subsequent clinical remission (cCR) and to propose endpoint benchmarks for future consolidation studies. PATIENTS AND METHODS.: The patient populations consisted of those (1) untreated (U; observed until progression; n=35, (2) receiving imatinib (G; n=32), (3) receiving goserelin and bicalutamide (A; n=32), and (4) receiving vaccine (V; n=68; total=167). The endpoint of the combined analysis was progression-free survival in second remission (PFS 2). Patient characteristics were compared by chi-square test, and factors predicting PFS 2 evaluated in multivariate Cox model. RESULTS.: Groups were comparable for age, stage, grade, and debulking. Multivariate model to predict PFS 2 duration included histology, stage, optimal debulking, PFS 1 duration, and the type of intervention. As a benchmark for future studies, the median PFS 2 of the combined population of G, A, and U (removing V which had the most impact in prolonging PFS 2, n=68) was 11.3 months (95% CI: 10.4-12.5 months). The percent of patients with PFS 2>PFS 1 was 14/90 (16%). At 12 months, 43% remain progression-free. CONCLUSION.: Preliminary benchmarks for efficacy endpoints are suggested for future consolidation trials of patients in cCR. However, the suggested strategies will require validation in randomized trials and larger data sets.
authors.affiliation: Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. sabbatip@mskcc.org
authors.forename: Paul
authors.initials: P
authors.lastname: Sabbatini
authors.forename: David
authors.initials: D
authors.lastname: Spriggs
authors.forename: Carol
authors.initials: C
authors.lastname: Aghajanian
authors.forename: Martee
authors.initials: M
authors.lastname: Hensley
authors.forename: William
authors.initials: W
authors.lastname: Tew
authors.forename: Jason
authors.initials: J
authors.lastname: Konner
authors.forename: Kathryn
authors.initials: K
authors.lastname: Bell-McGuinn
authors.forename: Margrit
authors.initials: M
authors.lastname: Juretzka
authors.forename: Alexia
authors.initials: A
authors.lastname: Iasonos
mesh_terms: D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000628:therapy*; D012074:Remission Induction