title: Impact of Chemotherapy Beyond the Third Line in Patients With Recurrent Epithelial Ovarian Cancer.
abstract: OBJECTIVE
  The goal of this study was to determine the benefit in terms of time disease control (TDC) achieved by the succession of chemotherapy beyond the third line in patients treated for recurrent epithelial ovarian cancer. Secondary objectives were to identify patients who benefited from treatments beyond 3 lines and to estimate overall survival and disease-free progression lengths.
  
  
  METHODS
  The cohort of 122 patients was identified from a pharmacy database of patients treated with chemotherapy between 1992 and 2010. The evaluation of benefit obtained by each line was based on TDC duration, defined as the interval between the beginning of the treatment and the date of progressive disease or death.
  
  
  RESULTS
  Median TDC durations was 4.15 (0-54.7), 4 (0-21.7), 3.34 (0-29.6), 4.97 (0-29.2), and 3.13 months (0-15) for the fourth to eighth lines, respectively. Time to disease control was longer than 6 months in 34% to 40% of patients treated by lines 4 to 8. The most important factor influencing TDC length beyond the third line was the TDC duration observed in the 2 previous lines of therapy. Median overall survival after the third line was 15.3 months (95% confidence interval, 12-20 months). Factors associated with longer overall survival after 3 lines were performance status lower than 2 (P = 0.0058), no hepatic metastasis (P = 0.0098), no pulmonary metastasis (P = 0.0003), and platinum sensitivity (P = 0.04) CONCLUSIONS: These results may justify the administration of chemotherapy beyond the third line, in particular when the 2 previous lines are effective and resulted in disease control longer than 6 months.
authors.affiliation: *EA4267-UFR-33, School of Medecine and Pharmacy; †Medical Oncology Unit, J. Minjoz University Teaching Hospital; ‡INSERM U 645, EA-2284 IFR-133; and §Department of Surgery and ∥Pharmacy Department, J. Minjoz University Hospital, Besançon, France.
authors.forename: Laura
authors.initials: L
authors.lastname: Mansi
authors.forename: Martin
authors.initials: M
authors.lastname: Demarchi
authors.forename: Fernando
authors.initials: F
authors.lastname: Bazan
authors.forename: Delphine
authors.initials: D
authors.lastname: Delroeux
authors.forename: Loïc
authors.initials: L
authors.lastname: Chaigneau
authors.forename: Antoine
authors.initials: A
authors.lastname: Thiery-Vuillemin
authors.forename: Sandrine
authors.initials: S
authors.lastname: Bernhard
authors.forename: Zaher
authors.initials: Z
authors.lastname: Lakkis
authors.forename: Zaehr
authors.initials: Z
authors.lastname: Lakkis
authors.forename: Virginie
authors.initials: V
authors.lastname: Nerich
authors.forename: Xavier
authors.initials: X
authors.lastname: Pivot
authors.forename: Elsa
authors.initials: E
authors.lastname: Kalbacher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy*; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents