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Tjokrowidjaja A, Friedlander ML, Ledermann JA, Coleman RL, Mirza MR, Matulonis UA, Pujade-Lauraine E, Lord SJ, Scott CL, Goble S, York W, Lee CK. Poor Concordance Between Cancer Antigen-125 and RECIST Assessment for Progression in Patients With Platinum-Sensitive Relapsed Ovarian Cancer on Maintenance Therapy With a Poly(ADP-ribose) Polymerase Inhibitor. J Clin Oncol 2024; 42:1301-1310. [PMID: 38215359 DOI: 10.1200/jco.23.01182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/22/2023] [Accepted: 10/25/2023] [Indexed: 01/14/2024] Open
Abstract
PURPOSE Cancer antigen-125 (CA-125) is recommended by treatment guidelines and widely used to diagnose ovarian cancer recurrence. The value of CA-125 as a surrogate for disease progression (PD) and its concordance with radiologic progression are unclear, particularly for women with platinum-sensitive relapsed ovarian cancer (PSROC) who have responded to chemotherapy and treated with maintenance poly(ADP-ribose) polymerase inhibitor (PARPi). METHODS In this pooled analysis of four randomized trials of maintenance PARPi or placebo (Study 19, SOLO2, ARIEL3, and NOVA), we extracted data on CA-125 PD as defined by Gynecologic Cancer InterGroup criteria and RECIST v1.1. We evaluated the concordance between CA-125 and RECIST PD and reported on the negative predictive value (NPV) and positive predictive value (PPV). RESULTS Of 1,262 participants (n = 818 PARPi, n = 444 placebo), 403 (32%) had CA-125 PD, and of these, 366 had concordant RECIST PD (PPV, 91% [95% CI, 88 to 93]). However, of 859 (68%) without CA-125 PD, 382 also did not have RECIST PD (NPV, 44% [95% CI, 41 to 48]). Within the treatment arms, PPV remained high (PARPi, 91% [95% CI, 86 to 94]; placebo, 91% [95% CI, 86 to 95]) but NPV was lower on placebo (PARPi, 53% [95% CI, 49 to 57]; placebo, 25% [95% CI, 20 to 31]). Of 477 with RECIST-only PD, most (95%) had a normal CA-125 at the start of maintenance therapy and the majority (n = 304, 64%) had CA-125 that remained within normal range. Solid organ recurrence without peritoneal disease was more common in those with RECIST-only PD than in those with CA-125 and RECIST PD (36% v 24%; P < .001). CONCLUSION In patients with PSROC treated with maintenance PARPi, almost half with RECIST PD did not have CA-125 PD, challenging current guidelines. Periodic computed tomography imaging should be considered as part of surveillance, particularly in those with a normal CA-125 at the start of maintenance therapy and on treatment.
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Affiliation(s)
- Angelina Tjokrowidjaja
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, Australia
- Australia New Zealand Gynecological Oncology Group, Camperdown, Australia
| | - M L Friedlander
- Australia New Zealand Gynecological Oncology Group, Camperdown, Australia
- University of New South Wales Clinical School, Prince of Wales Hospital, Sydney, Australia
| | - Jonathan A Ledermann
- University College London (UCL) Cancer Institute and UCL Hospitals, London, United Kingdom
| | | | - Mansoor R Mirza
- Department of Oncology, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark
- Nordic Society of Gynecological Oncology, Copenhagen, Denmark
| | - Ursula A Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Eric Pujade-Lauraine
- Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Paris, France
- Group d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Paris, France
| | - Sarah J Lord
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, Australia
| | - Clare L Scott
- Australia New Zealand Gynecological Oncology Group, Camperdown, Australia
- Walter and Eliza Hall Institute of Medical Research, Cancer Biology and Stem Cells Division, University of Melbourne, Melbourne, Australia
| | | | | | - Chee K Lee
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, Australia
- Australia New Zealand Gynecological Oncology Group, Camperdown, Australia
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Mirza MR, González-Martín A, Graybill WS, O'Malley DM, Gaba L, Stephanie Yap OW, Guerra EM, Rose PG, Baurain JF, Ghamande SA, Denys H, Prendergast E, Pisano C, Follana P, Baumann K, Calvert PM, Korach J, Li Y, Malinowska IA, Gupta D, Monk BJ. A plain language summary of publication of the efficacy and safety of individualized niraparib dosing based on baseline body weight and platelet count in the PRIMA/ENGOT-OV26/GOG-3012 trial. Future Oncol 2024; 20:799-809. [PMID: 38251916 DOI: 10.2217/fon-2023-0755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
WHAT IS THIS SUMMARY ABOUT? This document provides a summary of results from the article that evaluated the safety and efficacy of the fixed and individualized starting doses of niraparib in the PRIMA study. The original article was published in the journal Cancer in March 2023. The PRIMA study included adult patients with newly diagnosed advanced ovarian cancer who had finished treatment with chemotherapy and surgery. Once patients entered the study, they were treated with an oral (by mouth) medication called niraparib or placebo (substance with no effects that a doctor gives to a patient instead of a drug). The amount of drug (dose) prescribed for patients to take at the start of treatment was determined by the study plan (a document that describes in detail how the study will be performed). Some patients were treated with a fixed starting dose (300 milligrams [mg] once daily), while others were treated with an individualized dose (200 or 300 mg once daily) based on how much they weighed and the results of their blood test. The individualized dose was tested to see if it improved patient safety without changing its efficacy (how well the drug worked). WHAT WERE THE RESULTS? The individualized starting dose of niraparib improved patient safety, with a lower proportion of patients experiencing side effects than the fixed starting dose. The individualized starting dose of niraparib also delayed the cancer from coming back (recurring) or getting worse (progressing) compared with placebo. The delay in the cancer coming back or getting worse with niraparib treatment was generally similar in patients who received the individualized starting dose and those who received the fixed starting dose of niraparib. WHAT DO THE RESULTS MEAN? The results support the use of the individualized starting dose of niraparib, which uses a patient's body weight and blood test results to determine how much drug they should receive at the start of treatment. The study found that the individualized starting dose improved safety compared with the fixed starting dose while still delaying the cancer from coming back or getting worse. Clinical Trial Registration: NCT02655016 (PRIMA study) (ClinicalTrials.gov).
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Affiliation(s)
- Mansoor R Mirza
- Rigshospitalet, Copenhagen University Hospital & Nordic Society of Gynaecologic Oncology Clinical Trial Unit, Copenhagen, Denmark
| | - Antonio González-Martín
- Medical Oncology Department & Program in Solid Tumours-CIMA, Cancer Center Clínica Universidad de Navarra, Madrid, & Grupo Español de Investigación en Cáncer de Ovario (GEICO), Madrid, Spain
| | | | - David M O'Malley
- The Ohio State University & the James Comprehensive Cancer Center, Columbus, OH, USA
| | - Lydia Gaba
- Hospital Clinic de Barcelona, Translational Genomics & Targeted Therapies in Solid Tumors, Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Eva M Guerra
- Breast & Gynaecological Cancer Unit, Hospital Ramón y Cajal, Madrid, Spain
| | | | - Jean-François Baurain
- Université Catholique de Louvain & Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | | | | | - Emily Prendergast
- Minnesota Oncology, Minneapolis, Minnesota, USA, when the analysis was conducted; currently at Intermountain Medical Group, Salt Lake City, UT, USA
| | - Carmela Pisano
- Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Philippe Follana
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO) & Département D'Oncologie Médicale, Centre Antoine Lacassagne, Nice, France
| | - Klaus Baumann
- Arbeitsgemeinschaft Gynäkologische Onkologie & the Department of Gynecology & Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany
| | - Paula M Calvert
- Cancer Trials Ireland, Dublin, Ireland, when the analysis was conducted; currently at University Hospital Waterford, Waterford, Ireland
| | - Jacob Korach
- Gynecologic Oncology Department, The Chaim Sheba Medical Center, Sackler Medical School, Tel Aviv University, Ramat Gan, Israel
| | - Yong Li
- GSK, Waltham, MA, USA, when the analysis was conducted; currently at Adagio Therapeutics, Waltham, MA, USA
| | | | - Divya Gupta
- GSK, Waltham, MA, USA, when the analysis was conducted; currently at Adagio Therapeutics, Waltham, MA, USA
- GSK, Waltham, MA, USA, when the analysis was conducted; currently at Mersana Therapeutics, Inc, Cambridge, MA, USA
| | - Bradley J Monk
- HonorHealth Research Institute, University of Arizona, Creighton University, Phoenix, AZ, USA, when the study was conducted; present affiliation GOG Foundation; Florida Cancer Specialists & Research Institute, West Palm Beach, FL, USA
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3
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González-Martín A, Pothuri B, Vergote I, Graybill W, Lorusso D, McCormick CC, Freyer G, Backes F, Heitz F, Redondo A, Moore RG, Vulsteke C, O'Cearbhaill RE, Malinowska IA, Shtessel L, Compton N, Mirza MR, Monk BJ. Progression-free survival and safety at 3.5 years of follow-up: results from the randomized phase 3 PRIMA/ENGOT-OV26/GOG-3012 trial of niraparib maintenance treatment in patients with newly diagnosed ovarian cancer - a plain language summary. Future Oncol 2024. [PMID: 38501262 DOI: 10.2217/fon-2023-0782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Abstract
WHAT IS THIS SUMMARY ABOUT? This PLSP provides a short summary of an original scientific article that presented results from the PRIMA study after 3.5 years of follow-up time. The original article was published in the European Journal of Cancer in 2023. The PRIMA study included adult patients with newly diagnosed advanced high-risk ovarian cancer whose tumors shrunk or became undetectable after treatment with chemotherapy with or without surgery. The PRIMA study evaluated how well the drug niraparib, also known as Zejula, worked at delaying or preventing ovarian cancer from coming back (recurring) or getting worse (progressing) compared with placebo (a substance with no effects that a doctor gives to a patient instead of a drug). The first results from the PRIMA study were published in 2019, when patients had participated in the PRIMA study for about 1.2 years. The article this PLSP is based on reports longer-term data from the PRIMA study, when patients had participated in the PRIMA study for about 3.5 years. Patients were monitored (or followed) for a longer time to understand how well niraparib continued to work and to evaluate whether the safety of niraparib changed with additional time being monitored. WHAT WERE THE RESULTS? Patients who took niraparib had more time before their cancer came back or got worse than patients who took placebo. In terms of safety, no new types of side effects with niraparib treatment were observed with additional time being monitored as part of the PRIMA study. WHAT DO THE RESULTS MEAN? These results support that niraparib remains an important treatment option to help delay the cancer from coming back or getting worse in patients with newly diagnosed advanced ovarian cancer that responded to initial treatment. Clinical Trial Registration: NCT02655016 (PRIMA study) (ClinicalTrials.gov).
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Affiliation(s)
- Antonio González-Martín
- Medical Oncology Department, Cancer Center Clínica Universidad de Navarra, Madrid, Program in Solid Tumours, CIMA, Pamplona, & Grupo Español de Investigación en Cáncer de Ovario (GEICO), Madrid, Spain
| | - Bhavana Pothuri
- Gynecologic Oncology Group (GOG Foundation), NYU Langone Health, Department of Obstetrics & Gynecology, Perlmutter Cancer Center, New York, NY, USA
| | - Ignace Vergote
- Belgium & Luxembourg Gynaecological Oncology Group (BGOG), Department of Gynaecology & Obstetrics, Division of Gynaecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium, European Union
| | - Whitney Graybill
- GOG, Gynecologic Oncology, Medical University of South Carolina, Charleston, SC, USA
| | - Domenica Lorusso
- Multicentre Italian Trials in Ovarian Cancer & Gynecologic Malignancies (MITO), Fondazione Policlinico Gemelli IRCCS & Catholic University of Sacred Heart, Rome, Italy, when the study was conducted; present affiliation Humanitas San Pio X, Milan, Humanitas University, Rozzano, Italy
| | | | - Gilles Freyer
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), HCL Cancer Institute, Department of Medical Oncology, Lyon University, Lyon, France
| | - Floor Backes
- Division of Gynecologic Oncology, Ohio State University, Columbus, OH, USA
| | - Florian Heitz
- AGO Study Group & the Department for Gynaecology & Gynaecologic Oncology, Kliniken Essen-Mitte, Essen, & Charité - Universitätsmedizin Berlin, Humboldt- Universität zu Berlin, Berlin Institute of Health, Department of Gynaecology, Berlin, Germany
| | - Andrés Redondo
- GEICO, Department of Medical Oncology, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
| | - Richard G Moore
- Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics & Gynecology, University of Rochester, Rochester, NY, USA
| | - Christof Vulsteke
- BGOG, Department of Medical Oncology & Hematology, AZ Maria Middelares, Gent, & Department of Molecular Imaging, Pathology, Radiotherapy & Oncology, Center for Oncological Research, Antwerp University, Antwerp, Belgium
| | - Roisin E O'Cearbhaill
- GOG, Gynecologic Medical Oncology, Memorial Sloan Kettering Cancer Center, & Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | | | | | | | - Mansoor R Mirza
- Department of Oncology, Rigshospitalet-Copenhagen University Hospital & Nordic Society of Gynaecological Oncology, Copenhagen, Denmark
| | - Bradley J Monk
- HonorHealth Research Institute, University of Arizona College of Medicine, Phoenix Creighton University, Phoenix, AZ, USA, when the study was conducted; present affiliation GOG Foundation; Florida Cancer Specialists & Research Institute, West Palm Beach, FL, USA
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Bogani G, Monk BJ, Powell MA, Westin SN, Slomovitz B, Moore KN, Eskander RN, Raspagliesi F, Barretina-Ginesta MP, Colombo N, Mirza MR. Adding immunotherapy to first-line treatment of advanced and metastatic endometrial cancer. Ann Oncol 2024:S0923-7534(24)00056-5. [PMID: 38431043 DOI: 10.1016/j.annonc.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Immunotherapy has transformed the endometrial cancer treatment landscape, particularly for those exhibiting mismatch repair deficiency [MMRd/microsatellite instability-hypermutated (MSI-H)]. A growing body of evidence supports the integration of immunotherapy with chemotherapy as a first-line treatment strategy. Recently, findings from ongoing trials such as RUBY (NCT03981796), NRG-GY018 (NCT03914612), AtTEnd (NCT03603184), and DUO-E (NCT04269200) have been disclosed. MATERIALS AND METHODS This paper constitutes a review and meta-analysis of phase III trials investigating the role of immunotherapy in the first-line setting for advanced or recurrent endometrial cancer. RESULTS The pooled data from 2320 patients across these trials substantiate the adoption of chemotherapy alongside immunotherapy, revealing a significant improvement in progression-free survival compared to chemotherapy alone [hazard ratio (HR) 0.70, 95% confidence interval (CI) 0.62-0.79] across all patient groups. Progression-free survival benefits are more pronounced in MMRd/MSI-H tumors (n = 563; HR 0.33, 95% CI 0.23-0.43). This benefit, albeit less robust, persists in the MMR-proficient/microsatellite stable group (n = 1757; HR 0.74, 95% CI 0.60-0.91). Pooled data further indicate that chemotherapy plus immunotherapy enhances overall survival compared to chemotherapy alone in all patients (HR 0.75, 95% CI 0.63-0.89). However, overall survival data maturity remains low. CONCLUSIONS The incorporation of immunotherapy into the initial treatment for advanced and metastatic endometrial cancer brings about a substantial improvement in oncologic outcomes, especially within the MMRd/MSI-H subset. This specific subgroup is currently a focal point of investigation for evaluating the potential of chemotherapy-free regimens. Ongoing exploratory analyses aim to identify non-responding patients eligible for inclusion in clinical trials.
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Affiliation(s)
- G Bogani
- Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.
| | - B J Monk
- GOG Foundation, Florida Cancer Specialists and Research Institute, West Palm Beach
| | - M A Powell
- Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis
| | - S N Westin
- University of Texas MD Anderson Cancer Center, Houston
| | - B Slomovitz
- Division of Gynecologic Oncology, Mount Sinai Medical Center, Miami Beach
| | - K N Moore
- Stephenson Cancer Center at the University of Oklahoma Medical Center, Oklahoma
| | - R N Eskander
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla, USA
| | - F Raspagliesi
- Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - M-P Barretina-Ginesta
- Medical Oncology, Catalan Institute of Oncology, Hospital Universitari Dr. Josep Trueta, Girona; Precision Oncology Group (OncoGIR-Pro), Institut d'Investigació Biomèdica de Girona (IDIBGI), Girona; Department of Medical Sciences, Girona University, Girona, Spain
| | - N Colombo
- Gynecologic Oncology Program, European Institute of Oncology IRCCS, Milan; Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - M R Mirza
- Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark
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Oaknin A, Pothuri B, Gilbert L, Sabatier R, Brown J, Ghamande S, Mathews C, O'Malley DM, Kristeleit R, Boni V, Gravina A, Banerjee S, Miller R, Pikiel J, Mirza MR, Dewal N, Antony G, Dong Y, Zografos E, Veneris J, Tinker AV. Safety, Efficacy, and Biomarker Analyses of Dostarlimab in Patients with Endometrial Cancer: Interim Results of the Phase I GARNET Study. Clin Cancer Res 2023; 29:4564-4574. [PMID: 37363992 PMCID: PMC10643997 DOI: 10.1158/1078-0432.ccr-22-3915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/15/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE This interim report of the GARNET phase I trial presents efficacy and safety of dostarlimab in patients with advanced or recurrent endometrial cancer (EC), with an analysis of tumor biomarkers as prognostic indicators. PATIENTS AND METHODS A total of 153 patients with mismatch repair deficient (dMMR)/microsatellite instability-high (MSI-H) and 161 patients with mismatch repair proficient (MMRp)/microsatellite stable (MSS) EC were enrolled and dosed. Patients received 500 mg dostarlimab every 3 weeks for four cycles, then 1,000 mg every 6 weeks until progression. Primary endpoints were objective response rate (ORR) and duration of response (DOR). RESULTS A total of 143 patients with dMMR/MSI-H EC and 156 patients with MMRp/MSS EC were evaluated for efficacy. ORR was 45.5% (n = 65) and 15.4% (n = 24) for dMMR/MSI-H EC and MMRp/MSS EC, respectively. Median DOR for dMMR/MSI-H EC was not met (median follow-up, 27.6 months); median DOR for MMRp/MSS EC was 19.4 months. The ORRs by combined positive score (CPS) ≥1 status were 54.9% and 21.7% for dMMR/MSI-H EC and MMRp/MSS EC, respectively. ORRs by high tumor mutational burden (≥10 mutations/Mb) were 47.8% (43/90) and 45.5% (5/11) for dMMR/MSI-H EC and MMRp/MSS EC, respectively. ORR in TP53mut or POLεmut molecular subgroups was 18.1% (17/94) and 40.0% (2/5), respectively. The safety profile of dostarlimab was consistent with previous reports. CONCLUSIONS Dostarlimab demonstrated durable antitumor activity and safety in patients with dMMR/MSI-H EC. Biomarkers associated with EC may identify patients likely to respond to dostarlimab. See related commentary by Jangra and Dhani, p. 4521.
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Affiliation(s)
- Ana Oaknin
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Bhavana Pothuri
- Gynecologic Oncology Group (GOG) and Department of Obstetrics/Gynecology, Laura & Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York
| | - Lucy Gilbert
- Division of Gynecologic Oncology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Renaud Sabatier
- Department of Medical Oncology, Institut Paoli Calmettes, Aix-Marseille University, Marseille, France
| | - Jubilee Brown
- Division of Gynecologic Oncology, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina
| | - Sharad Ghamande
- Department of Obstetrics and Gynecology, Georgia Cancer Center, Augusta University, Augusta, Georgia
| | - Cara Mathews
- Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | - David M. O'Malley
- Division of Gynecologic Oncology, The Ohio State University and the James Comprehensive Cancer Center, Columbus, Ohio
| | - Rebecca Kristeleit
- Department of Oncology, Guys and St Thomas' NHS Foundation Trust, London, United Kingdom
| | | | - Adriano Gravina
- Clinical Trials Unit, Istituto Nazionale Tumori - IRCCS - Fondazione “Pascale” di Napoli, Naples, Italy
| | - Susana Banerjee
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, United Kingdom
| | - Rowan Miller
- University College London, St. Bartholomew's Hospitals London, London, United Kingdom
| | - Joanna Pikiel
- Department of Chemotherapy, Regional Center of Oncology, Gdansk, Poland
| | - Mansoor R. Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital and Nordic Society of Gynaecologic Oncology–Clinical Trial Unit, Copenhagen, Denmark
| | | | | | | | | | | | - Anna V. Tinker
- BC Cancer - Vancouver, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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Herzog TJ, Wahab SA, Mirza MR, Pothuri B, Vergote I, Graybill WS, Malinowska IA, York W, Hurteau JA, Gupta D, González-Martin A, Monk BJ. Optimizing disease progression assessment using blinded central independent review and comparing it with investigator assessment in the PRIMA/ENGOT-ov26/GOG-3012 trial: challenges and solutions. Int J Gynecol Cancer 2023; 33:1733-1742. [PMID: 37931976 PMCID: PMC10646892 DOI: 10.1136/ijgc-2023-004605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/26/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVE Progression-free survival is an established clinically meaningful endpoint in ovarian cancer trials, but it may be susceptible to bias; therefore, blinded independent centralized radiological review is often included in trial designs. We compared blinded independent centralized review and investigator-assessed progressive disease performance in the PRIMA/ENGOT-ov26/GOG-3012 trial examining niraparib monotherapy. METHODS PRIMA/ENGOT-ov26/GOG-3012 was a randomized, double-blind phase 3 trial; patients with newly diagnosed stage III/IV ovarian cancer received niraparib or placebo. The primary endpoint was progression-free survival (per Response Evaluation Criteria in Solid Tumors [RECIST] v1.1), determined by two independent radiologists, an arbiter if required, and by blinded central clinician review. Discordance rates between blinded independent centralized review and investigator assessment of progressive disease and non-progressive disease were routinely assessed. To optimize disease assessment, a training intervention was developed for blinded independent centralized radiological reviewers, and RECIST refresher training was provided for investigators. Discordance rates were determined post-intervention. RESULTS There was a 39% discordance rate between blinded independent centralized review and investigator-assessed progressive disease/non-progressive disease in an initial patient subset (n=80); peritoneal carcinomatosis was the most common source of discordance. All reviewers underwent training, and as a result, changes were implemented, including removal of two original reviewers and identification of 10 best practices for reading imaging data. Post-hoc analysis indicated final discordance rates between blinded independent centralized review and investigator improved to 12% in the overall population. Median progression-free survival and hazard ratios were similar between blinded independent centralized review and investigators in the overall population and across subgroups. CONCLUSION PRIMA/ENGOT-ov26/GOG-3012 highlights the need to optimize blinded independent centralized review and investigator concordance using early, specialized, ovarian-cancer-specific radiology training to maximize validity of outcome data.
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Affiliation(s)
- Thomas J Herzog
- Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati, Ohio, USA
| | - Shaun A Wahab
- Department of Radiology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Mansoor R Mirza
- Department of Oncology, Nordic Society of Gynaecological Oncology Clinical Trial Unit (NSGO-CTU) and Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark
| | - Bhavana Pothuri
- Department of Obstetrics and Gynecology, NYU Langone Health Perlmutter Cancer Center, New York, New York, USA
| | - Ignace Vergote
- Department of Obstetrics and Gynecology, Leuven Cancer Institute, Catholic University Leuven, Leuven, Belgium
| | - Whitney S Graybill
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina, USA
| | | | - Whitney York
- Oncology Statistics, GSK, Upper Providence, Pennsylvania, USA
| | - Jean A Hurteau
- Synthetic Lethality & Immuno-oncology, GSK, Waltham, Massachusetts, USA
| | - Divya Gupta
- Synthetic Lethality, GSK, Waltham, Massachusetts, USA
| | - Antonio González-Martin
- Department of Medical Oncology, Grupo Español de Investigación en Cáncer de Ovario (GEICO), Program in Solid Tumors, Center for Applied Medical Research (CIMA), Madrid, Spain
| | - Bradley J Monk
- Department of Obstetrics and Gynecology, HonorHealth Research Institute, University of Arizona College of Medicine, Phoenix, Arizona, USA
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7
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Corbaux P, You B, Glasspool RM, Yanaihara N, Tinker AV, Lindemann K, Ray-Coquard IL, Mirza MR, Subtil F, Colomban O, Péron J, Karamouza E, McNeish I, Kelly C, Kagimura T, Welch S, Lewsley LA, Paoletti X, Cook A. Survival and modelled cancer antigen-125 ELIMination rate constant K score in ovarian cancer patients in first-line before poly(ADP-ribose) polymerase inhibitor era: A Gynaecologic Cancer Intergroup meta-analysis. Eur J Cancer 2023; 191:112966. [PMID: 37542936 DOI: 10.1016/j.ejca.2023.112966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/16/2023] [Accepted: 06/28/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND In patients with advanced ovarian cancer, the modelled CA-125 ELIMination rate constant K (KELIM) is an early indicator of the tumour intrinsic chemosensitivity. We assessed the prognostic and surrogate values of KELIM with respect to those of surgery outcome (based on post-operative residual lesions) in the Gynaecologic Cancer Intergroup (GCIG) individual patient data meta-analysis MAOV (Meta-Analysis in OVarian cancer) built before the emergence of poly(ADP-ribose) polymerase (PARP) inhibitors. METHODS The dataset was split into learning and validation cohorts (ratio 1:2). The individual modelled KELIM values were estimated, standardised by the median value, then scored as unfavourable (<1.0) or favourable (≥1.0). Overall survival (OS) and progression-free survival (PFS) analyses were performed with a two-step meta-analytic approach and surrogacy through a two-level meta-analytic model. RESULTS KELIM was assessed in 5884 patients from eight first-line trials (learning, 1962; validation, 3922). A favourable KELIM score was significantly associated with longer OS (validation set, median, 78.8 versus 28.4 months, hazard-ratios [HR] 0.46, 95% confidence interval [CI], 0.41-0.50, C-index 0.68), and longer PFS (validation set, median 30.5 versus 9.8 months, HR 0.49, 95% CI, 0.45-0.54, C-index 0.68), as were International Federation of Gynaecology and Obstetrics (FIGO) stage and debulking surgery outcome. Three prognostic groups were identified based on the surgery outcome and KELIM score, with large differences in OS (105.1, ∼45.0, and 22.1 months) and PFS (58.1, ∼15.0, and 8.0 months). Surrogacy for OS and for PFS was not established. CONCLUSION KELIM is an independent prognostic biomarker for survival, complementary to surgery outcome, representing a new determinant of first-line treatment success.
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Affiliation(s)
- Pauline Corbaux
- EA UCBL/HCL 3738, Centre pour l'lnnovation en Cancérologie de Lyon (CICLY), Faculty of Medicine Lyon-Sud, Claude Bernard University Lyon 1, Lyon, France; Medical Oncology, Institut de Cancérologie et d'Hématologie Universitaire de Saint-Étienne (ICHUSE), Centre Hospitalier Universitaire de Saint-Etienne, France
| | - Benoit You
- EA UCBL/HCL 3738, Centre pour l'lnnovation en Cancérologie de Lyon (CICLY), Faculty of Medicine Lyon-Sud, Claude Bernard University Lyon 1, Lyon, France; Medical Oncology, Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), CITOHL, Centre Hospitalier Lyon-Sud, GINECO, GINEGEPS, Lyon, France.
| | - Rosalind M Glasspool
- Beatson West of Scotland Cancer Centre, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Nozomu Yanaihara
- Department of Obstetrics and Gynecologye, The Jikei University School of Medicine, Tokyo, Japan
| | - Anna V Tinker
- Medical Oncology, BC Cancer - Vancouver, Vancouver, Canada
| | - Kristina Lindemann
- Department of Gynaecological Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Mansoor R Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Clinical Trial Unit, Nordic Society of Gynaecological Oncology, Copenhagen, Denmark
| | - Fabien Subtil
- Department of Biostatistics, Hospices Civils de Lyon, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique Santé, CNRS UMR 5558, Claude Bernard University Lyon 1, Lyon, France
| | - Olivier Colomban
- EA UCBL/HCL 3738, Centre pour l'lnnovation en Cancérologie de Lyon (CICLY), Faculty of Medicine Lyon-Sud, Claude Bernard University Lyon 1, Lyon, France
| | - Julien Péron
- Medical Oncology, Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), CITOHL, Centre Hospitalier Lyon-Sud, GINECO, GINEGEPS, Lyon, France; Department of Biostatistics, Hospices Civils de Lyon, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique Santé, CNRS UMR 5558, Claude Bernard University Lyon 1, Lyon, France
| | - Eleni Karamouza
- Institut Gustave Roussy, Office of Biostatistics and Epidemiology, Université Paris-Saclay, Villejuif, France; Inserm, Université Paris-Saclay, CESP U1018, Oncostat, labelled Ligue Contre le Cancer, Villejuif, France
| | - Iain McNeish
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Caroline Kelly
- Cancer Research UK Clinical Trial Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Tatsuo Kagimura
- Foundation for Biomedical Research and Innovation at Kobe, Translational Research Center for Medical Innovation, Kobe, Japan
| | - Stephen Welch
- Department of Oncology, London Health Sciences Centre, London, Ontario, Canada
| | - Liz-Anne Lewsley
- Cancer Research UK Clinical Trial Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Adrian Cook
- Medical Research Council Clinical Trials Unit, University College London, London, UK
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8
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González-Martín A, Pothuri B, Vergote I, Graybill W, Lorusso D, McCormick CC, Freyer G, Backes F, Heitz F, Redondo A, Moore RG, Vulsteke C, O'Cearbhaill RE, Malinowska IA, Shtessel L, Compton N, Mirza MR, Monk BJ. Progression-free survival and safety at 3.5years of follow-up: results from the randomised phase 3 PRIMA/ENGOT-OV26/GOG-3012 trial of niraparib maintenance treatment in patients with newly diagnosed ovarian cancer. Eur J Cancer 2023; 189:112908. [PMID: 37263896 DOI: 10.1016/j.ejca.2023.04.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE To report updated long-term efficacy and safety from the double-blind, placebo-controlled, phase 3 PRIMA/ENGOT-OV26/GOG-3012 study (NCT02655016). METHODS Patients with newly diagnosed advanced ovarian cancer with complete or partial response (CR or PR) to first-line platinum-based chemotherapy received niraparib or placebo once daily (2:1 ratio). Stratification factors were best response to first-line chemotherapy regimen (CR/PR), receipt of neoadjuvant chemotherapy (yes/no), and homologous recombination deficiency (HRD) status (deficient [HRd]/proficient [HRp] or not determined). Updated (ad hoc) progression-free survival (PFS) data (as of November 17, 2021) by investigator assessment (INV) are reported. RESULTS In 733 randomised patients (niraparib, 487; placebo, 246), median PFS follow-up was 3.5years. Median INV-PFS was 24.5 versus 11.2months (hazard ratio, 0.52; 95% confidence interval [CI], 0.40-0.68) in the HRd population and 13.8 versus 8.2months (hazard ratio, 0.66; 95% CI, 0.56-0.79) in the overall population for niraparib and placebo, respectively. In the HRp population, median INV-PFS was 8.4 versus 5.4months (hazard ratio, 0.65; 95% CI, 0.49-0.87), respectively. Results were concordant with the primary analysis. Niraparib-treated patients were more likely to be free of progression or death at 4years than placebo-treated patients (HRd, 38% versus 17%; overall, 24% versus 14%). The most common grade ≥ 3 treatment-emergent adverse events in niraparib patients were thrombocytopenia (39.7%), anaemia (31.6%), and neutropenia (21.3%). Myelodysplastic syndromes/acute myeloid leukaemia incidence rate (1.2%) was the same for niraparib- and placebo-treated patients. Overall survival remained immature. CONCLUSIONS Niraparib maintained clinically significant improvements in PFS with 3.5years of follow-up in patients with newly diagnosed advanced ovarian cancer at high risk of progression irrespective of HRD status. No new safety signals were identified.
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Affiliation(s)
- Antonio González-Martín
- Medical Oncology Department, Cancer Center Clínica Universidad de Navarra, Madrid, Program in Solid Tumours, CIMA, Pamplona, and Grupo Español de Investigación en Cáncer de Ovario (GEICO), Madrid, Spain
| | - Bhavana Pothuri
- Gynecologic Oncology Group (GOG Foundation), NYU Langone, Health, Department of Obstetrics & Gynecology, Perlmutter Cancer Center, New York, NY, USA
| | - Ignace Vergote
- Belgium and Luxembourg Gynaecological Oncology Group (BGOG), Department of Gynaecology and Obstetrics, Division of Gynaecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Whitney Graybill
- GOG, Gynecologic Oncology, Medical University of South Carolina, Charleston, SC, USA
| | - Domenica Lorusso
- Multicentre Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO), Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome, Italy
| | | | - Gilles Freyer
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), HCL Cancer Institute Department of Medical Oncology, Lyon University, Lyon, France
| | - Floor Backes
- Division of Gynecologic Oncology, Ohio State University, Columbus, OH, USA
| | - Florian Heitz
- AGO Study Group and the Department for Gynaecology and Gynaecologic Oncology, Kliniken Essen-Mitte, Essen, Germany; Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Gynaecology, Berlin, Germany
| | - Andrés Redondo
- GEICO, Department of Medical Oncology, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
| | - Richard G Moore
- Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
| | - Christof Vulsteke
- BGOG, Department of Medical Oncology and Hematology, AZ Maria Middelares, Gent, Belgium; Department of Molecular Imaging, Pathology, Radiotherapy & Oncology, Center for Oncological Research, Antwerp University, Antwerp, Belgium
| | - Roisin E O'Cearbhaill
- GOG, Gynecologic Medical Oncology, Memorial Sloan Kettering Cancer Center, and Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | | | | | | | - Mansoor R Mirza
- Department of Oncology, Rigshospitalet-Copenhagen University Hospital and Nordic Society of Gynaecological Oncology, Copenhagen, Denmark
| | - Bradley J Monk
- HonorHealth Research Institute, University of Arizona College of Medicine, Phoenix Creighton University, Phoenix, AZ, USA
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9
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Mirza MR, Chase DM, Slomovitz BM, dePont Christensen R, Novák Z, Black D, Gilbert L, Sharma S, Valabrega G, Landrum LM, Hanker LC, Stuckey A, Boere I, Gold MA, Auranen A, Pothuri B, Cibula D, McCourt C, Raspagliesi F, Shahin MS, Gill SE, Monk BJ, Buscema J, Herzog TJ, Copeland LJ, Tian M, He Z, Stevens S, Zografos E, Coleman RL, Powell MA. Dostarlimab for Primary Advanced or Recurrent Endometrial Cancer. N Engl J Med 2023; 388:2145-2158. [PMID: 36972026 DOI: 10.1056/nejmoa2216334] [Citation(s) in RCA: 132] [Impact Index Per Article: 132.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
BACKGROUND Dostarlimab is an immune-checkpoint inhibitor that targets the programmed cell death 1 receptor. The combination of chemotherapy and immunotherapy may have synergistic effects in the treatment of endometrial cancer. METHODS We conducted a phase 3, global, double-blind, randomized, placebo-controlled trial. Eligible patients with primary advanced stage III or IV or first recurrent endometrial cancer were randomly assigned in a 1:1 ratio to receive either dostarlimab (500 mg) or placebo, plus carboplatin (area under the concentration-time curve, 5 mg per milliliter per minute) and paclitaxel (175 mg per square meter of body-surface area), every 3 weeks (six cycles), followed by dostarlimab (1000 mg) or placebo every 6 weeks for up to 3 years. The primary end points were progression-free survival as assessed by the investigator according to Response Evaluation Criteria in Solid Tumors (RECIST), version 1.1, and overall survival. Safety was also assessed. RESULTS Of the 494 patients who underwent randomization, 118 (23.9%) had mismatch repair-deficient (dMMR), microsatellite instability-high (MSI-H) tumors. In the dMMR-MSI-H population, estimated progression-free survival at 24 months was 61.4% (95% confidence interval [CI], 46.3 to 73.4) in the dostarlimab group and 15.7% (95% CI, 7.2 to 27.0) in the placebo group (hazard ratio for progression or death, 0.28; 95% CI, 0.16 to 0.50; P<0.001). In the overall population, progression-free survival at 24 months was 36.1% (95% CI, 29.3 to 42.9) in the dostarlimab group and 18.1% (95% CI, 13.0 to 23.9) in the placebo group (hazard ratio, 0.64; 95% CI, 0.51 to 0.80; P<0.001). Overall survival at 24 months was 71.3% (95% CI, 64.5 to 77.1) with dostarlimab and 56.0% (95% CI, 48.9 to 62.5) with placebo (hazard ratio for death, 0.64; 95% CI, 0.46 to 0.87). The most common adverse events that occurred or worsened during treatment were nausea (53.9% of the patients in the dostarlimab group and 45.9% of those in the placebo group), alopecia (53.5% and 50.0%), and fatigue (51.9% and 54.5%). Severe and serious adverse events were more frequent in the dostarlimab group than in the placebo group. CONCLUSIONS Dostarlimab plus carboplatin-paclitaxel significantly increased progression-free survival among patients with primary advanced or recurrent endometrial cancer, with a substantial benefit in the dMMR-MSI-H population. (Funded by GSK; RUBY ClinicalTrials.gov number, NCT03981796.).
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Affiliation(s)
- Mansoor R Mirza
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Dana M Chase
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Brian M Slomovitz
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - René dePont Christensen
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Zoltán Novák
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Destin Black
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Lucy Gilbert
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Sudarshan Sharma
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Giorgio Valabrega
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Lisa M Landrum
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Lars C Hanker
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Ashley Stuckey
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Ingrid Boere
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Michael A Gold
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Annika Auranen
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Bhavana Pothuri
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - David Cibula
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Carolyn McCourt
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Francesco Raspagliesi
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Mark S Shahin
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Sarah E Gill
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Bradley J Monk
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Joseph Buscema
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Thomas J Herzog
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Larry J Copeland
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Min Tian
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Zangdong He
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Shadi Stevens
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Eleftherios Zografos
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Robert L Coleman
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
| | - Matthew A Powell
- From the Department of Oncology, Rigshospitalet, Copenhagen University Hospital, and the Nordic Society of Gynaecological Oncology-Clinical Trial Unit, Copenhagen (M.R.M.), and the Research Unit for General Practice, University of Southern Denmark, Institute of Public Health, Odense (R.C.) - all in Denmark; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (D.M.C.); the Department of Gynecologic Oncology, Mount Sinai Medical Center, and the Department of Obstetrics and Gynecology, Florida International University, Miami Beach (B.M.S.); the Department of Gynecology, Hungarian National Institute of Oncology, Budapest, Hungary (Z.N.); the Department of Obstetrics and Gynecology, Louisiana State University Health Shreveport, and Willis-Knighton Physician Network, Shreveport (D.B.); the Division of Gynecologic Oncology, McGill University Health Centre, Montreal (L.G.); the Department of Obstetrics and Gynecology, AMITA Adventist Hinsdale Hospital, Hinsdale, IL (S.S.); the University of Turin, A.O. Ordine Mauriziano, Turin (G.V.), and the Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori-Milano, University of Milan, Milan (F.R.) - both in Italy; Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany (L.C.H.); Women and Infants Hospital, Providence, RI (A.S.); the Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands (I.B.); Oklahoma Cancer Specialists and Research Institute, Tulsa (M.A.G.); Tays Cancer Center and FICAN Mid, Tampere University and Tampere University Hospital, Tampere, Finland (A.A.); New York University Langone Health, New York (B.P.); the Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic (D.C.); the Division of Gynecologic Oncology (C.M.) and National Cancer Institute-sponsored NRG Oncology (M.A.P.), Washington University School of Medicine, St. Louis; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Asplundh Cancer Pavilion, Sidney Kimmel Medical College, Thomas Jefferson University, Willow Grove (M.S.S.), and GSK, Collegeville (M.T., Z.H.) - both in Pennsylvania; the Division of Gynecologic Oncology, Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA (S.E.G.); HonorHealth Research Institute, University of Arizona College of Medicine, and Creighton University School of Medicine, Phoenix (B.J.M.), and the Department of Gynecologic Oncology, Arizona Oncology, Tucson (J.B.); the Department of Obstetrics and Gynecology, University of Cincinnati Cancer Center, Cincinnati (T.J.H.), and Ohio State University Comprehensive Cancer Center, Hillard (L.J.C.); GSK, London (S.S., E.Z.); and US Oncology Research, the Woodlands, TX (R.L.C.)
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Mirza MR, González-Martín A, Graybill WS, O'Malley DM, Gaba L, Stephanie Yap OW, Guerra EM, Rose PG, Baurain JF, Ghamande SA, Denys H, Prendergast E, Pisano C, Follana P, Baumann K, Calvert PM, Korach J, Li Y, Malinowska IA, Gupta D, Monk BJ. Prospective evaluation of the tolerability and efficacy of niraparib dosing based on baseline body weight and platelet count: Results from the PRIMA/ENGOT-OV26/GOG-3012 trial. Cancer 2023; 129:1846-1855. [PMID: 37060236 DOI: 10.1002/cncr.34706] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/12/2022] [Accepted: 08/17/2022] [Indexed: 04/16/2023]
Abstract
BACKGROUND The PRIMA/ENGOT-OV26/GOG-3012 (NCT02655016) trial was amended to prospectively evaluate the safety and efficacy of an individualized starting dose (ISD) regimen of niraparib for first-line maintenance therapy in patients with newly diagnosed advanced ovarian cancer. METHODS In the phase 3 PRIMA trial, patients with newly diagnosed advanced ovarian cancer with a complete/partial response to first-line platinum-based chemotherapy (N = 733) were initially treated with a fixed starting dose (FSD) regimen of 300 mg every day. Subsequently, the protocol was amended so newly enrolled patients received an ISD: 200 mg every day in patients with baseline body weight < 77 kg or baseline platelet count < 150,000/µL, and 300 mg every day in all other patients. Efficacy and safety outcomes were assessed by starting dose. RESULTS Overall, 475 (64.8%) patients were assigned to an FSD (niraparib, n = 317; placebo, n = 158) and 258 (35.2%) were assigned to an ISD (niraparib, n = 170; placebo, n = 88). Efficacy in patients who received FSD or ISD was similar for the overall (FSD hazard ratio [HR], 0.59 [95% CI, 0.46-0.76] vs. ISD HR, 0.69 [95% CI, 0.48-0.98]) and the homologous recombination-deficient (FSD HR, 0.44 [95% CI, 0.30-0.64] vs. ISD HR, 0.39 [95% CI, 0.22-0.72]) populations. In patients with low body weight/platelet count, rates of grades ≥3 and 4 hematologic treatment-emergent adverse events, dose interruptions, and dose reductions were lower for those who received ISD than for those who received FSD. CONCLUSIONS In PRIMA, similar dose intensity, similar efficacy, and improved safety were observed with the ISD compared with the FSD regimen.
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Affiliation(s)
- Mansoor R Mirza
- NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark
| | - Antonio González-Martín
- Medical Oncology Department, Grupo Español de Investigación en Cáncer de Ovario (GEICO), Clínica Universidad de Navarra, Madrid, Spain
- Program in Solid Tumors, Center for Applied Medical Research (CIMA), Pamplona, Spain
| | - Whitney S Graybill
- GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - David M O'Malley
- James Comprehensive Cancer Center, Ohio State University, Columbus, Ohio, USA
| | - Lydia Gaba
- Medical Oncology Department, Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapies in Solid Tumors, Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Eva M Guerra
- Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Jean-François Baurain
- Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | | | | | | | - Carmela Pisano
- Istituto Nazionale Tumori IRCCS Fondazione Pascale, Naples, Italy
| | | | - Klaus Baumann
- Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany
| | | | - Jacob Korach
- Gynecologic Oncology Department, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yong Li
- GSK, Waltham, Massachusetts, USA
| | | | | | - Bradley J Monk
- HonorHealth Research Institute, University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix, Arizona, USA
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Monk BJ, González-Martin A, Buckley L, Matulonis UA, Rimel BJ, Wu X, Moore KN, Mirza MR. Safety and management of niraparib monotherapy in ovarian cancer clinical trials. Int J Gynecol Cancer 2023:ijgc-2022-004079. [PMID: 36792166 DOI: 10.1136/ijgc-2022-004079] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Niraparib is a poly (ADP-ribose) polymerase inhibitor that has shown a significant improvement in progression-free survival irrespective of biomarker status in patients with advanced epithelial ovarian cancer. This review focuses on the adverse events associated with niraparib and their management to maintain efficacy of niraparib treatment and improve quality of life for patients. In five trials assessing efficacy of niraparib in patients with advanced epithelial ovarian cancer (PRIMA, NOVA, NORA, QUADRA, and PRIME), treatment-emergent adverse events of any grade were reported in nearly all patients (≥99%) receiving niraparib; the events were grade ≥3 in 51-74% of patients. Across all lines of therapy, treatment-emergent adverse events led to dose interruptions in 62-80% of patients receiving niraparib and dose reductions in 47-71%. Hematologic events were most frequently reported, including thrombocytopenia, anemia, and neutropenia. Common non-hematologic events included gastrointestinal events, which were generally low grade (<5% were grade ≥3). Clinical strategies to manage these and other events, such as fatigue and insomnia, cognitive behavioral therapy and pharmacologic agents, are summarized. Once-daily niraparib dosing may be advantageous for some patients for many reasons, including night-time dosing which may help alleviate gastrointestinal symptoms. An individualized starting dose (determined by baseline body weight and platelet count) of niraparib demonstrated an improved safety profile while maintaining efficacy. Patients receiving the niraparib individualized starting dose had fewer grade ≥3 adverse events, dose interruptions, and dose reductions than patients receiving a fixed starting dose. The safety profile of niraparib across five pivotal studies in advanced epithelial ovarian cancer was consistent across multiple lines of treatment, including as maintenance therapy in first-line and recurrent settings and as treatment in heavily pre-treated patients. Long-term safety data from the NOVA trial confirmed that, with appropriate and early dose modifications, niraparib is well tolerated.
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Affiliation(s)
- Bradley J Monk
- HonorHealth Research Institute, Phoenix, Arizona, USA .,University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Antonio González-Martin
- Grupo Español de Investigación en Cáncer de Ovario (GEICO), Madrid, Spain.,Program in Solid Tumors, Center for Applied Medical Research (CIMA) and Medical Oncology Department, Clínica Universidad de Navarra, Madrid, Spain
| | | | - Ursula A Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - B J Rimel
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Xiaohua Wu
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Kathleen N Moore
- Department of Obstetrics and Gynecology, Stephenson Cancer Center at the University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Mansoor R Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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12
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González-Martín A, Desauw C, Heitz F, Cropet C, Gargiulo P, Berger R, Ochi H, Vergote I, Colombo N, Mirza MR, Tazi Y, Canzler U, Zamagni C, Guerra-Alia EM, Levaché CB, Marmé F, Bazan F, de Gregorio N, Dohollou N, Fasching PA, Scambia G, Rubio-Pérez MJ, Milenkova T, Costan C, Pautier P, Ray-Coquard I. Maintenance olaparib plus bevacizumab in patients with newly diagnosed advanced high-grade ovarian cancer: Main analysis of second progression-free survival in the phase III PAOLA-1/ENGOT-ov25 trial. Eur J Cancer 2022; 174:221-231. [PMID: 36067615 DOI: 10.1016/j.ejca.2022.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND PAOLA-1/ENGOT-ov25 (NCT02477644) demonstrated a significant progression-free survival (PFS) benefit with maintenance olaparib plus bevacizumab versus placebo plus bevacizumab in newly diagnosed, advanced ovarian cancer. We report the prespecified main second progression-free survival (PFS2) analysis for PAOLA-1. METHODS This randomised, double-blind, phase III trial was conducted in 11 countries. Eligible patients had newly diagnosed, advanced, high-grade ovarian cancer and were in response after first-line platinum-based chemotherapy plus bevacizumab. Patients were randomised 2:1 to olaparib (300 mg twice daily) or placebo for up to 24 months; all patients received bevacizumab (15 mg/kg every 3 weeks) for up to 15 months. Primary PFS end-point was reported previously. Time from randomisation to second disease progression or death was a key secondary end-point included in the hierarchical-testing procedure. RESULTS After a median follow-up of 35.5 months and 36.5 months, respectively, median PFS2 was 36.5 months (olaparib plus bevacizumab) and 32.6 months (placebo plus bevacizumab), hazard ratio 0.78; 95% confidence interval (CI) 0.64-0.95; P = 0.0125. Median time to second subsequent therapy or death was 38.2 months (olaparib plus bevacizumab) and 31.5 months (placebo plus bevacizumab), hazard ratio 0.78; 95% CI 0.64-0.95; P = 0.0115. Seventy-two (27%) patients in the placebo plus bevacizumab group received a poly(ADP-ribose) polymerase inhibitor as first subsequent therapy. No new safety signals were observed for olaparib plus bevacizumab. CONCLUSION In newly diagnosed, advanced ovarian cancer, maintenance olaparib plus bevacizumab provided continued benefit beyond first progression, with a significant PFS2 improvement and a time to second subsequent therapy or death delay versus placebo plus bevacizumab.
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Affiliation(s)
- Antonio González-Martín
- Grupo Español de Investigación en Cáncer de Ovario (GEICO), Spain and MD Anderson Cancer Center Madrid, Spain.
| | - Christophe Desauw
- Centre Hospitalier Régional Universitaire de Lille, Lille, and Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), France
| | - Florian Heitz
- Department of Gynecology and Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Essen; European Competence Center of Ovarian Cancer, Charité Campus Virchow-Klinikum, Charité- Universitaetsmedizin Berlin, Berlin; corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO), Germany
| | | | - Piera Gargiulo
- Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Napoli, and Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO), Italy
| | - Regina Berger
- Department for Gynaecology and Obstetrics, Medical University of Innsbruck, Innsbruck, and AGO-Austria, Austria
| | - Hiroyuki Ochi
- University of Tsukuba, Ibaraki, and Gynecologic Oncology Trial and Investigation Consortium (GOTIC), Japan
| | - Ignace Vergote
- University Hospital Leuven, Leuven Cancer Institute, Leuven, and Belgian and Luxembourg Gynaecological Oncology Group (BGOG), Belgium
| | - Nicoletta Colombo
- University of Milan-Bicocca and IEO European Institute of Oncology IRCCS, Milan, and Mario Negri Gynecologic Oncology Group (MANGO), Italy
| | - Mansoor R Mirza
- Rigshospitalet, Copenhagen University Hospital, and Nordic Society of Gynecologic Oncology (NSGO), Denmark
| | - Youssef Tazi
- Strasbourg Oncologie Libérale, Strasbourg, and GINECO, France
| | - Ulrich Canzler
- Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, and AGO, Germany
| | - Claudio Zamagni
- IRCCS Azienda Ospedaliero-universitaria di Bologna, Bologna, and MITO, Italy
| | - Eva M Guerra-Alia
- Hospital Universitario Ramón y Cajal, Madrid, and Grupo Español de Investigación en Cáncer de Ovario (GEICO), Spain
| | | | - Frederik Marmé
- Medical Faculty Mannheim, Heidelberg University, Heidelberg, and AGO, Germany
| | - Fernando Bazan
- Centre Hospitalier Regional Universitaire de Besançon, Besançon, and GINECO, France
| | | | - Nadine Dohollou
- Polyclinique Bordeaux Nord Aquitaine, Bordeaux, and GINECO, France
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, and AGO, Germany
| | - Giovanni Scambia
- Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome, and MITO, Italy
| | | | | | | | | | - Isabelle Ray-Coquard
- Centre Léon BERARD and University Claude Bernard Lyon 1, Lyon, and GINECO, France
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13
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Oaknin A, Bosse TJ, Creutzberg CL, Giornelli G, Harter P, Joly F, Lorusso D, Marth C, Makker V, Mirza MR, Ledermann JA, Colombo N. Endometrial cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 2022; 33:860-877. [PMID: 35690222 DOI: 10.1016/j.annonc.2022.05.009] [Citation(s) in RCA: 123] [Impact Index Per Article: 61.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/27/2022] [Accepted: 05/19/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- A Oaknin
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - T J Bosse
- Departments of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - C L Creutzberg
- Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - G Giornelli
- Department of Oncology, Instituto Alexander Fleming, Buenos Aires, Argentina
| | - P Harter
- Department of Gynecology & Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Essen, Germany
| | - F Joly
- ANTICIPE, Cancer and Cognition Platform, Normandie University, Caen, France; Medical Oncology Department, Centre François Baclesse, Caen, France
| | - D Lorusso
- Department of Life Science and Public Health, Catholic University of Sacred Heart, Largo Agostino Gemelli, Rome, Italy; Department of Women and Child Health, Division of Gynaecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - C Marth
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria
| | - V Makker
- Gynecologic Medical Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical College, New York, USA
| | - M R Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - J A Ledermann
- Cancer Institute, University College London (UCL), London, UK; Department of Oncology, UCL Hospitals, London, UK
| | - N Colombo
- Department of Gynecologic Oncology, Istituto Europeo di Oncologia IRCCS, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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14
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González-Martín A, Matulonis UA, Korach J, Mirza MR, Moore KN, Wu X, York W, Gupta D, Lechpammer S, Monk BJ. Niraparib treatment for patients with BRCA-mutated ovarian cancer: review of clinical data and therapeutic context. Future Oncol 2022; 18:2505-2536. [PMID: 35791804 DOI: 10.2217/fon-2022-0206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
We reviewed clinical data for niraparib monotherapy in BRCA-mutated (BRCAm) epithelial ovarian cancer (OC), contextualizing results with data from other poly(ADP-ribose) polymerase inhibitors (PARPis). Niraparib reduced the likelihood of progression or death by 60% as first-line maintenance therapy and by 73-78% in recurrent disease. In heavily pretreated OC, efficacy was greater in the BRCAm versus non-BRCAm cohort. Quality-of-life (QoL) was maintained throughout treatment. Adverse events were consistent with the known niraparib safety profile. Cumulative efficacy, safety and QoL evidence demonstrate niraparib maintenance monotherapy has a positive benefit:risk ratio in BRCAm OC. Niraparib significantly improved progression-free survival as first-line maintenance therapy in all patients with OC (i.e., of any biomarker status).
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Affiliation(s)
- Antonio González-Martín
- Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Medical Oncology Department, Clínica Universidad de Navarra, Madrid, Spain & Program in Solid Tumors, Center for Applied Medical Research (CIMA), Madrid, 31008, Spain
| | - Ursula A Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Jacob Korach
- Gynecologic Oncology Department, Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel Aviv University, 69978, Israel
| | - Mansoor R Mirza
- Department of Oncology, Rigshospitalet Copenhagen University Hospital, Copenhagen, 2100, Denmark
| | - Kathleen N Moore
- Department of Gynecologic Oncology, Stephenson Cancer Center at the University of Oklahoma Health Science Center, Oklahoma City, OK 73104 & Sarah Cannon Research Institute, Nashville, TN 37203, USA
| | - Xiaohua Wu
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
| | - Whitney York
- GlaxoSmithKline, Upper Providence, PA 19426, USA
| | | | | | - Bradley J Monk
- HonorHealth Research Institute & Department of Obstetrics and Gynecology, University of Arizona, Creighton University, Phoenix, AZ 85258, USA
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15
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Vergote I, González-Martín A, Ray-Coquard I, Harter P, Colombo N, Pujol P, Lorusso D, Mirza MR, Brasiuniene B, Madry R, Brenton JD, Ausems MGEM, Büttner R, Lambrechts D. European experts consensus: BRCA/homologous recombination deficiency testing in first-line ovarian cancer. Ann Oncol 2022; 33:276-287. [PMID: 34861371 DOI: 10.1016/j.annonc.2021.11.013] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Homologous recombination repair (HRR) enables fault-free repair of double-stranded DNA breaks. HRR deficiency is predicted to occur in around half of high-grade serous ovarian carcinomas. Ovarian cancers harbouring HRR deficiency typically exhibit sensitivity to poly-ADP ribose polymerase inhibitors (PARPi). Current guidelines recommend a range of approaches for genetic testing to identify predictors of sensitivity to PARPi in ovarian cancer and to identify genetic predisposition. DESIGN To establish a European-wide consensus for genetic testing (including the genetic care pathway), decision making and clinical management of patients with recently diagnosed advanced ovarian cancer, and the validity of biomarkers to predict the effectiveness of PARPi in the first-line setting. The collaborative European experts' consensus group consisted of a steering committee (n = 14) and contributors (n = 84). A (modified) Delphi process was used to establish consensus statements based on a systematic literature search, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. RESULTS A consensus was reached on 34 statements amongst 98 caregivers (including oncologists, pathologists, clinical geneticists, genetic researchers, and patient advocates). The statements concentrated on (i) the value of testing for BRCA1/2 mutations and HRR deficiency testing, including when and whom to test; (ii) the importance of developing new and better HRR deficiency tests; (iii) the importance of germline non-BRCA HRR and mismatch repair gene mutations for predicting familial risk, but not for predicting sensitivity to PARPi, in the first-line setting; (iv) who should be able to inform patients about genetic testing, and what training and education should these caregivers receive. CONCLUSION These consensus recommendations, from a multidisciplinary panel of experts from across Europe, provide clear guidance on the use of BRCA and HRR deficiency testing for recently diagnosed patients with advanced ovarian cancer.
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Affiliation(s)
- I Vergote
- Division of Gynaecological Oncology, Department of Gynaecology and Obstetrics and Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.
| | - A González-Martín
- Clinica Universidad de Navarra, Madrid, Spain; Program for Solid Tumors at Centro de Investigación Médica Aplicada (CIMA), Pamplona, Spain
| | - I Ray-Coquard
- Medical Oncology, Centre Leon Bérard and Université Claude Bernard Lyon, Lyon, France
| | - P Harter
- Department of Gynaecology & Gynaecologic Oncology, Ev. Kliniken Essen-Mitte, Essen, Germany
| | - N Colombo
- University of Milan-Bicocca and European Institute of Oncology IRCCS, Milan, Italy
| | - P Pujol
- Montpellier Faculty of Medicine, University Hospital of Montpellier, Montpellier, France
| | - D Lorusso
- Department of Women and Child Science and Public Health, Catholic University of Rome, Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | - M R Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - B Brasiuniene
- Department of Medical Oncology, National Cancer Institute of Lithuania, Faculty of Medicine of Vilnius University, Vilnius, Lithuania
| | - R Madry
- Oncological Gynaecology Department, Poznan University of Medical Sciences, Poznan, Poland
| | - J D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - M G E M Ausems
- Division Laboratories, Pharmacy and Biomedical Genetics, Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R Büttner
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - D Lambrechts
- Department of Human Genetics, VIB and KU Leuven, Leuven, Belgium
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16
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Harter P, Sehouli J, Vergote I, Ferron G, Reuss A, Meier W, Greggi S, Mosgaard BJ, Selle F, Guyon F, Pomel C, Lécuru F, Zang R, Avall-Lundqvist E, Kim JW, Ponce J, Raspagliesi F, Kristensen G, Classe JM, Hillemanns P, Jensen P, Hasenburg A, Ghaem-Maghami S, Mirza MR, Lund B, Reinthaller A, Santaballa A, Olaitan A, Hilpert F, du Bois A. Randomized Trial of Cytoreductive Surgery for Relapsed Ovarian Cancer. N Engl J Med 2021; 385:2123-2131. [PMID: 34874631 DOI: 10.1056/nejmoa2103294] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Treatment for patients with recurrent ovarian cancer has been mainly based on systemic therapy. The role of secondary cytoreductive surgery is unclear. METHODS We randomly assigned patients with recurrent ovarian cancer who had a first relapse after a platinum-free interval (an interval during which no platinum-based chemotherapy was used) of 6 months or more to undergo secondary cytoreductive surgery and then receive platinum-based chemotherapy or to receive platinum-based chemotherapy alone. Patients were eligible if they presented with a positive Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) score, defined as an Eastern Cooperative Oncology Group performance-status score of 0 (on a 5-point scale, with higher scores indicating greater disability), ascites of less than 500 ml, and complete resection at initial surgery. A positive AGO score is used to identify patients in whom a complete resection might be achieved. The primary end point was overall survival. We also assessed quality of life and prognostic factors for survival. RESULTS A total of 407 patients underwent randomization: 206 were assigned to cytoreductive surgery and chemotherapy, and 201 to chemotherapy alone. A complete resection was achieved in 75.5% of the patients in the surgery group who underwent the procedure. The median overall survival was 53.7 months in the surgery group and 46.0 months in the no-surgery group (hazard ratio for death, 0.75; 95% confidence interval, 0.59 to 0.96; P = 0.02). Patients with a complete resection had the most favorable outcome, with a median overall survival of 61.9 months. A benefit from surgery was seen in all analyses in subgroups according to prognostic factors. Quality-of-life measures through 1 year of follow-up did not differ between the two groups, and we observed no perioperative mortality within 30 days after surgery. CONCLUSIONS In women with recurrent ovarian cancer, cytoreductive surgery followed by chemotherapy resulted in longer overall survival than chemotherapy alone. (Funded by the AGO Study Group and others; DESKTOP III ClinicalTrials.gov number, NCT01166737.).
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Affiliation(s)
- Philipp Harter
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Jalid Sehouli
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Ignace Vergote
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Gwenael Ferron
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Alexander Reuss
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Werner Meier
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Stefano Greggi
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Berit J Mosgaard
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Frederic Selle
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Frédéric Guyon
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Christophe Pomel
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Fabrice Lécuru
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Rongyu Zang
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Elisabeth Avall-Lundqvist
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Jae-Weon Kim
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Jordi Ponce
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Francesco Raspagliesi
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Gunnar Kristensen
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Jean-Marc Classe
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Peter Hillemanns
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Pernille Jensen
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Annette Hasenburg
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Sadaf Ghaem-Maghami
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Mansoor R Mirza
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Bente Lund
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Alexander Reinthaller
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Ana Santaballa
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Adeola Olaitan
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Felix Hilpert
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
| | - Andreas du Bois
- From the Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen (P. Harter, A.B.), the Department of Gynecology with Center for Oncological Surgery, Charité Berlin, Berlin (J.S.), the Coordinating Center for Clinical Trials (A. Reuss) and Department of Gynecology (P. Harter), Philipps University, Marburg, the Department of Obstetrics and Gynecology, Heinrich-Heine-University, Duesseldorf (W.M.), the Department of Gynecology and Obstetrics, Hannover Medical School, Hannover (P. Hillemanns), the University Medical Center Mainz, Department of Gynecology and Obstetrics, Mainz (A.H.), and Mammazentrum Hamburg at Jerusalem Hospital, Hamburg (F.H.) - all in Germany; the Department of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium (I.V.); the Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse (G.F.), the Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon (F.S.), and Institut Curie, Oncologie Gynécologique and Université de Paris (F.L.), Paris, the Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux (F.G.), the Department of Surgical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand (C.P.), and Institut de Cancerologie de l'Ouest, Université de Médecine, Nantes (J.-M.C.) - all in France; the Gynecologic Oncology Unit, Istituto Nazionale Tumori di Napoli, Fondazione IRCCS Pascale, Naples (S.G.), and Fondazione IRCCS Istituto Nazionale Tumori, Milan (F.R.) - both in Italy; the Gyne-Oncology Department of Gynecology (B.J.M.), Copenhagen University Hospital Rigshospitalet (M.R.M.), Copenhagen, the Department of Gynecology, Aarhus University Hospital and Aarhus University, Institute of Clinical Medicine, Faculty of Health, Aarhus (P.J.), and Aalborg University Hospital, Aalborg (B.L.) - all in Denmark; the Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, Shanghai, China (R.Z.); the Department of Oncology-Pathology, Karolinska Institutet, Stockholm (E.A.-L.); the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.-W.K.); University Hospital of Bellvitge, Barcelona (J.P.), and the Gynecologic Oncology Unit, La Fe University Hospital, Valencia (A.S.) - both in Spain; the Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo (G.K.); the Department of Surgery and Cancer, Imperial College London (S.G.-M.), and the Department of Gynaecological Oncology, University College London Hospital (A.O.) - both in London; and the Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna (A. Reinthaller)
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17
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Sztupinszki Z, Diossy M, Börcsök J, Prosz A, Cornelius N, Kjeldsen MK, Mirza MR, Szallasi Z. Comparative Assessment of Diagnostic Homologous Recombination Deficiency associated mutational signatures in ovarian cancer. Clin Cancer Res 2021; 27:5681-5687. [PMID: 34380641 DOI: 10.1158/1078-0432.ccr-21-0981] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/08/2021] [Accepted: 08/09/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Homologous recombination (HR) deficiency is one of the key determinants of PARP inhibitor response in ovarian cancer, and its accurate detection in tumor biopsies is expected to improve the efficacy of this therapy. Since HR deficiency induces a wide array of genomic aberrations, mutational signatures may serve as a companion diagnostic to identify PARP inhibitor responsive cases. METHODS From the TCGA whole exome sequencing data we extracted different types of mutational signature-based HR deficiency measures, such as the HRD score, genome-wide LOH and HRDetect trained on ovarian and breast cancer specific sequencing data. We compared their performance to identify BRCA1/2 deficient cases in the TCGA ovarian cancer cohort and predict survival benefit in platinum treated, BRCA1/2 wild type ovarian cancer. RESULTS We found that the HRD score, which is based on large chromosomal alterations alone, performed similarly well to an ovarian cancer specific HRDetect, which incorporates mutations on a finer scale as well (AUC=0.823 versus AUC=0.837). In an independent cohort these two methods were equally accurate predicting long term survival after platinum treatment (AUC=0.787 versus AUC=0.823). We also found that HRDetect trained on ovarian cancer was more accurate than HRDetect trained on breast cancer data (AUC=0.837 versus AUC=0.795, p=0.0072). CONCLUSION When WES data are available, methods that quantify only large chromosomal alterations such as the HRD score and HRDetect that captures a wider array of HR deficiency induced genomic aberrations are equally efficient identifying HR deficient ovarian cancer cases.
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Affiliation(s)
| | - Miklos Diossy
- Translational Cancer Genomics, Danish Cancer Society Research Center
| | - Judit Börcsök
- Translational Cancer Genomics, Danish Cancer Society Research Center
| | - Aurel Prosz
- Translational Cancer Genomics, Danish Cancer Society Research Center
| | | | | | | | - Zoltan Szallasi
- Children's Hospital Informatics Program at the Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School
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18
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Lee CK, Friedlander ML, Tjokrowidjaja A, Ledermann JA, Coleman RL, Mirza MR, Matulonis UA, Pujade-Lauraine E, Bloomfield R, Goble S, Wang P, Glasspool RM, Scott CL. Molecular and clinical predictors of improvement in progression-free survival with maintenance PARP inhibitor therapy in women with platinum-sensitive, recurrent ovarian cancer: A meta-analysis. Cancer 2021; 127:2432-2441. [PMID: 33740262 DOI: 10.1002/cncr.33517] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/18/2021] [Accepted: 02/18/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND The authors performed a meta-analysis to better quantify the benefit of maintenance poly(ADP-ribose) polymerase inhibitor (PARPi) therapy to inform practice in platinum-sensitive, recurrent, high-grade ovarian cancer for patient subsets with the following characteristics: germline BRCA mutation (gBRCAm), somatic BRCA mutation (sBRCAm), wild-type BRCA but homologous recombinant-deficient (HRD), homologous recombinant-proficient (HRP), and baseline clinical prognostic characteristics. METHODS Randomized trials comparing a PARPi versus placebo as maintenance treatment were identified from electronic databases. Treatment estimates of progression-free survival were pooled across trials using the inverse variance weighted method. RESULTS Four trials included 972 patients who received a PARPi (olaparib, 31%; niraparib, 35%; or rucaparib, 34%) and 530 patients who received placebo. For patients who had germline BRCA1 mutation (gBRCAm1) (N = 471), the hazard ratio (HR) was 0.29 (95% CI, 0.23-0.37); for those who had germline BRCA2 mutation (gBRCAm2) (N = 236), the HR was 0.26 (95% CI, 0.17-0.39); and, for those who had sBRCAm (N = 123), the HR was 0.22 (95% CI, 0.12-0.41). The treatment effect was similar between the gBRCAm and sBRCAm subsets (P = .48). In patients who had wild-type BRCA HRD tumors (excluding sBRCAm; N = 309), the HR was 0.41 (95% CI, 0.31-0.56); and, in those who had wild-type BRCA HRP tumors (N = 346), the HR was 0.64 (95% CI, 0.49-0.83). The relative treatment effect was greater for the BRCAm versus HRD (P = .03), BRCAm versus HRP (P < .00001), and HRD versus HRP (P < .00001) subsets. There was no difference in benefit based on age, response after recent chemotherapy, and prior bevacizumab. CONCLUSIONS In platinum-sensitive, recurrent, high-grade ovarian cancer, maintenance PARPi improves progression-free survival for all patient subsets. PARPi therapy has a similar magnitude of benefit for sBRCAm and gBRCAm. Although patients with BRCAm derive the greatest benefit, the absence of a BRCAm or HRD could not be used to exclude patients from maintenance PARPi therapy.
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Affiliation(s)
- Chee Khoon Lee
- National Health and Medical Research Council Clinical Trials Center, University of Sydney, Sydney, New South Wales, Australia.,Australia New Zealand Gynecological Oncology Group, Camperdown, New South Wales, Australia
| | - Michael L Friedlander
- Australia New Zealand Gynecological Oncology Group, Camperdown, New South Wales, Australia.,University of New South Wales Clinical School, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Angelina Tjokrowidjaja
- National Health and Medical Research Council Clinical Trials Center, University of Sydney, Sydney, New South Wales, Australia.,Australia New Zealand Gynecological Oncology Group, Camperdown, New South Wales, Australia
| | - Jonathan A Ledermann
- University College London (UCL) Cancer Institute and UCL Hospitals, London, United Kingdom
| | - Robert L Coleman
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mansoor R Mirza
- Department of Oncology, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark.,Nordic Society of Gynecological Oncology, Copenhagen, Denmark
| | - Ursula A Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Eric Pujade-Lauraine
- Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Paris, France.,Group d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Paris, France
| | | | | | - Ping Wang
- GlaxoSmithKline, Waltham, Massachusetts
| | - Rosalind M Glasspool
- Beatson West of Scotland Cancer Center, National Health Service Greater Glasgow and Clyde and University of Glasgow, Glasgow, United Kingdom.,Scottish Gynecological Cancer Trials Group, University of Glasgow, Glasgow, United Kingdom
| | - Clare L Scott
- Australia New Zealand Gynecological Oncology Group, Camperdown, New South Wales, Australia.,Walter and Eliza Hall Institute of Medical Research, Stem Cells, and Cancer, University of Melbourne, Melbourne, Victoria, Australia
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19
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Mirza MR, Benigno B, Dørum A, Mahner S, Bessette P, Barceló IB, Berton-Rigaud D, Ledermann JA, Rimel BJ, Herrstedt J, Lau S, du Bois A, Herráez AC, Kalbacher E, Buscema J, Lorusso D, Vergote I, Levy T, Wang P, de Jong FA, Gupta D, Matulonis UA. Long-term safety in patients with recurrent ovarian cancer treated with niraparib versus placebo: Results from the phase III ENGOT-OV16/NOVA trial. Gynecol Oncol 2020; 159:442-448. [PMID: 32981695 DOI: 10.1016/j.ygyno.2020.09.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/04/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Niraparib is a poly(ADP-ribose) polymerase (PARP) inhibitor approved for use in heavily pretreated patients and as maintenance treatment in patients with newly-diagnosed or recurrent ovarian cancer following a response to platinum-based chemotherapy. We present long-term safety data for niraparib from the ENGOT-OV16/NOVA trial. METHODS This multicenter, double-blind, randomized, controlled phase III trial evaluated the efficacy and safety of niraparib for the treatment of recurrent ovarian cancer. Patients were randomly assigned 2:1 to receive either once-daily niraparib 300 mg or placebo. Two independent cohorts were enrolled based on germline BRCA mutation status. The primary endpoint was progression-free survival, reported previously. Long-term safety data were from the most recent data cutoff (September 2017). RESULTS Overall, 367 patients received niraparib 300 mg once daily. Dose reductions due to TEAEs were highest in month 1 (34%) and declined every month thereafter. Incidence of any-grade and grade ≥ 3 hematologic and symptomatic TEAEs was also highest in month 1 and subsequently declined. Incidence of grade ≥ 3 thrombocytopenia decreased from 28% (month 1) to 9% and 5% (months 2 and 3, respectively), with protocol-directed dose interruptions and/or reductions. Acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) were reported in 2 and 6 niraparib-treated patients, respectively, and in 1 placebo patient each. Treatment discontinuations due to TEAEs were <5% in each month and time interval measured. CONCLUSION These data demonstrate the importance of appropriate dose reduction according to toxicity criteria and support the safe long-term use of niraparib for maintenance treatment in patients with recurrent ovarian cancer. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01847274.
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Affiliation(s)
- Mansoor R Mirza
- Nordic Society of Gynaecological Oncology Clinical Trial Unit (NSGO-CTU), Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark.
| | - B Benigno
- Northside Hospital, Atlanta, GA, USA
| | - A Dørum
- Radiumhospitalet, Oslo University Hospital, NSGO, Oslo, Norway
| | - S Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, AGO, Munich, Germany
| | - P Bessette
- Sherbrooke University, Sherbrooke, QC, Canada
| | | | - D Berton-Rigaud
- Institut de Cancérologie de l'Ouest Centre René Gauducheau, GINECO, Saint-Herblain, France
| | - J A Ledermann
- UCL Cancer Institute, University College London, NCRI, London, UK
| | - B J Rimel
- Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | - J Herrstedt
- Odense University Hospital, Odense, Denmark; Zealand University Hospital, NSGO, Roskilde, Denmark
| | - S Lau
- McGill University, Montreal, QC, Canada
| | - A du Bois
- Kliniken Essen Mitte, AGO, Essen, Germany
| | | | - E Kalbacher
- Centre Hospitalier Régional et Universitaire de Besançon, GINECO, Besançon, France
| | - J Buscema
- Arizona Oncology Associates, Tucson, AZ, USA
| | - D Lorusso
- Fondazione Policlinico Universitario a Gemelli IRCCS, Istituto Nazionale dei Tumori, MITO, Milan, Italy
| | - I Vergote
- University of Leuven, Leuven Cancer Institute, BGOG, Leuven, Belgium
| | - T Levy
- Wolfson Medical Center, ISGO, Holon, Israel
| | - P Wang
- GlaxoSmithKline, Waltham, MA, USA
| | | | - D Gupta
- GlaxoSmithKline, Waltham, MA, USA
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20
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Mirza MR, Coleman RL, González-Martín A, Moore KN, Colombo N, Ray-Coquard I, Pignata S. The forefront of ovarian cancer therapy: update on PARP inhibitors. Ann Oncol 2020; 31:1148-1159. [PMID: 32569725 DOI: 10.1016/j.annonc.2020.06.004] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND In recurrent ovarian cancer, poly(ADP-ribose) polymerase (PARP)-inhibiting agents have transformed the treatment of platinum-sensitive disease. New data support use of PARP inhibitors earlier in the treatment algorithm. DESIGN We review results from recent phase III trials evaluating PARP inhibitors as treatment and/or maintenance therapy for patients with newly diagnosed ovarian cancer. We discuss the efficacy and safety of these agents in the all-comer and biomarker-selected populations studied in clinical trials, and compare the strengths and limitations of the various trial designs. We also consider priorities for future research, with a particular focus on patient selection and future regimens for populations with high unmet need. RESULTS Four phase III trials (SOLO-1, PAOLA-1/ENGOT-OV25, PRIMA/ENGOT-OV26 and VELIA/GOG-3005) demonstrated remarkable improvements in progression-free survival with PARP inhibitor therapy (olaparib, niraparib or veliparib) for newly diagnosed ovarian cancer. Differences in trial design (treatment and/or maintenance setting; single agent or combination; bevacizumab or no bevacizumab), patient selection (surgical outcome, biomarker eligibility, prognosis) and primary analysis population (intention-to-treat, BRCA mutated or homologous recombination deficiency positive) affect the conclusions that can be drawn from these trials. Overall survival data are pending and there is limited experience regarding long-term safety. CONCLUSIONS PARP inhibitors play a pivotal role in the management of newly diagnosed ovarian cancer, which will affect subsequent treatment choices. Refinement of testing for patient selection and identification of regimens to treat populations that appear to benefit less from PARP inhibitors are a priority.
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Affiliation(s)
- M R Mirza
- Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark.
| | - R L Coleman
- Department of Gynecologic Oncology & Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, USA
| | - A González-Martín
- Medical Oncology Department, Clínica Universidad de Navarra, Madrid, Spain
| | - K N Moore
- Stephenson Cancer Center at the University of Oklahoma, Oklahoma City, USA
| | - N Colombo
- Division of Medical Gynecologic Oncology, European Institute of Oncology IRCCS, University of Milan-Bicocca, Milan, Italy
| | - I Ray-Coquard
- Centre Léon Bérard, University Claude Bernard Lyon I, Lyon, France
| | - S Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
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21
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Vergote IB, Lund B, Peen U, Umajuridze Z, Mau-Sorensen M, Kranich A, Van Nieuwenhuysen E, Haslund C, Nottrup T, Han SN, Concin N, Unger TJ, Chai Y, Au N, Rashal T, Joshi A, Crochiere M, Landesman Y, Shah J, Shacham S, Kauffman M, Mirza MR. Phase 2 study of the Exportin 1 inhibitor selinexor in patients with recurrent gynecological malignancies. Gynecol Oncol 2020; 156:308-314. [PMID: 31822399 DOI: 10.1016/j.ygyno.2019.11.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 10/24/2019] [Accepted: 11/08/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Selinexor is an oral inhibitor of the nuclear export protein Exportin 1 (XPO1) with demonstrated antitumor activity in solid and hematological malignancies. We evaluated the efficacy and safety of selinexor in heavily pretreated, recurrent gynecological malignancies. METHODS In this phase 2 trial, patients received selinexor (35 or 50 mg/m2 twice-weekly [BIW] or 50 mg/m2 once-weekly [QW]) in 4-week cycles. Primary endpoint was disease control rate (DCR) including complete response (CR), partial response (PR) or stable disease (SD) ≥12 weeks. Secondary endpoints were progression-free survival (PFS), overall survival (OS) and safety. RESULTS 114 patients with ovarian (N = 66), endometrial (N = 23) or cervical (N = 25) cancer were enrolled. Median number of prior regimens for ovarian, endometrial and cervical cancer was 6 (1-11), 2 (1-5), and 3 (1-6) respectively. DCR was 30% (ovarian 30%; endometrial 35%; cervical 24%), which included confirmed PRs in 8%, 9%, and 4% of patients with ovarian, endometrial, and cervical cancer respectively. Median PFS and OS for patients with ovarian, endometrial and cervical cancer were 2.6, 2.8 and 1.4 months, and 7.3, 7.0, and 5.0 months, respectively. Common Grade 3/4 adverse events (AEs) were thrombocytopenia (17%), fatigue (14%), anemia (10%), nausea (9%) and hyponatremia (9%). Patients with ovarian cancer receiving 50 mg/m2 QW had fewer high-grade AEs with similar efficacy as BIW treatment. CONCLUSIONS Selinexor demonstrated single-agent activity and disease control in patients with heavily pretreated ovarian and endometrial cancers. Side effects were a function of dose level and treatment frequency, similar to previous reports, reversible and mitigated with supportive care.
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Affiliation(s)
- I B Vergote
- Department of Obstetrics and Gynaecology, Division of Gynecologic Oncology, University Hospital Leuven, Leuven Cancer Institute, Leuven, Belgium, European Union.
| | - B Lund
- Aalborg University Hospital, Aalborg, Denmark
| | - U Peen
- Herlev University Hospital, Herlev, Denmark
| | - Z Umajuridze
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - M Mau-Sorensen
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - E Van Nieuwenhuysen
- Department of Obstetrics and Gynaecology, Division of Gynecologic Oncology, University Hospital Leuven, Leuven Cancer Institute, Leuven, Belgium, European Union
| | - C Haslund
- Aalborg University Hospital, Aalborg, Denmark
| | - T Nottrup
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - S N Han
- Department of Obstetrics and Gynaecology, Division of Gynecologic Oncology, University Hospital Leuven, Leuven Cancer Institute, Leuven, Belgium, European Union
| | - N Concin
- Department of Obstetrics and Gynaecology, Division of Gynecologic Oncology, University Hospital Leuven, Leuven Cancer Institute, Leuven, Belgium, European Union
| | - T J Unger
- Karyopharm Therapeutics Newton, MA, USA
| | - Y Chai
- Karyopharm Therapeutics Newton, MA, USA
| | - N Au
- Karyopharm Therapeutics Newton, MA, USA
| | - T Rashal
- Karyopharm Therapeutics Newton, MA, USA
| | - A Joshi
- Karyopharm Therapeutics Newton, MA, USA
| | | | | | - J Shah
- Karyopharm Therapeutics Newton, MA, USA
| | - S Shacham
- Karyopharm Therapeutics Newton, MA, USA
| | | | - M R Mirza
- Karyopharm Therapeutics Newton, MA, USA
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22
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González-Martín A, Pothuri B, Vergote I, DePont Christensen R, Graybill W, Mirza MR, McCormick C, Lorusso D, Hoskins P, Freyer G, Baumann K, Jardon K, Redondo A, Moore RG, Vulsteke C, O'Cearbhaill RE, Lund B, Backes F, Barretina-Ginesta P, Haggerty AF, Rubio-Pérez MJ, Shahin MS, Mangili G, Bradley WH, Bruchim I, Sun K, Malinowska IA, Li Y, Gupta D, Monk BJ. Niraparib in Patients with Newly Diagnosed Advanced Ovarian Cancer. N Engl J Med 2019; 381:2391-2402. [PMID: 31562799 DOI: 10.1056/nejmoa1910962] [Citation(s) in RCA: 1130] [Impact Index Per Article: 226.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Niraparib, an inhibitor of poly(adenosine diphosphate [ADP]-ribose) polymerase (PARP), has been associated with significantly increased progression-free survival among patients with recurrent ovarian cancer after platinum-based chemotherapy, regardless of the presence or absence of BRCA mutations. The efficacy of niraparib in patients with newly diagnosed advanced ovarian cancer after a response to first-line platinum-based chemotherapy is unknown. METHODS In this randomized, double-blind, phase 3 trial, we randomly assigned patients with newly diagnosed advanced ovarian cancer in a 2:1 ratio to receive niraparib or placebo once daily after a response to platinum-based chemotherapy. The primary end point was progression-free survival in patients who had tumors with homologous-recombination deficiency and in those in the overall population, as determined on hierarchical testing. A prespecified interim analysis for overall survival was conducted at the time of the primary analysis of progression-free survival. RESULTS Of the 733 patients who underwent randomization, 373 (50.9%) had tumors with homologous-recombination deficiency. Among the patients in this category, the median progression-free survival was significantly longer in the niraparib group than in the placebo group (21.9 months vs. 10.4 months; hazard ratio for disease progression or death, 0.43; 95% confidence interval [CI], 0.31 to 0.59; P<0.001). In the overall population, the corresponding progression-free survival was 13.8 months and 8.2 months (hazard ratio, 0.62; 95% CI, 0.50 to 0.76; P<0.001). At the 24-month interim analysis, the rate of overall survival was 84% in the niraparib group and 77% in the placebo group (hazard ratio, 0.70; 95% CI, 0.44 to 1.11). The most common adverse events of grade 3 or higher were anemia (in 31.0% of the patients), thrombocytopenia (in 28.7%), and neutropenia (in 12.8%). No treatment-related deaths occurred. CONCLUSIONS Among patients with newly diagnosed advanced ovarian cancer who had a response to platinum-based chemotherapy, those who received niraparib had significantly longer progression-free survival than those who received placebo, regardless of the presence or absence of homologous-recombination deficiency. (Funded by GlaxoSmithKline; PRIMA/ENGOT-OV26/GOG-3012 ClinicalTrials.gov number, NCT02655016.).
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Affiliation(s)
- Antonio González-Martín
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Bhavana Pothuri
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Ignace Vergote
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - René DePont Christensen
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Whitney Graybill
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Mansoor R Mirza
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Colleen McCormick
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Domenica Lorusso
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Paul Hoskins
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Gilles Freyer
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Klaus Baumann
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Kris Jardon
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Andrés Redondo
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Richard G Moore
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Christof Vulsteke
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Roisin E O'Cearbhaill
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Bente Lund
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Floor Backes
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Pilar Barretina-Ginesta
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Ashley F Haggerty
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Maria J Rubio-Pérez
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Mark S Shahin
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Giorgia Mangili
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - William H Bradley
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Ilan Bruchim
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Kaiming Sun
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Izabela A Malinowska
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Yong Li
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Divya Gupta
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
| | - Bradley J Monk
- From Grupo Español de Investigación en Cáncer de Ovario (GEICO) and the Medical Oncology Department, Clínica Universidad de Navarra (A.G.-M.) and GEICO and Hospital Universitario La Paz-IdiPAZ (A.R.), Madrid, GEICO and Medical Oncology, Catalan Institute of Oncology, Girona Biomedical Research Institute, and the Department of Medical Sciences, Medical School University of Girona, Girona (P.B.-G.), and GEICO and Hospital Universitario Reina Sofía, Cordoba (M.J.R.-P.) - all in Spain; the Gynecologic Oncology Group (GOG) and the Department of Obstetrics/Gynecology, Perlmutter Cancer Center, NYU Langone Health (B.P.), and GOG and the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (R.E.O.), New York, and US Oncology Research (USOR) and the Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester (R.G.M.) - all in New York; Belgium and Luxembourg Gynecologic Oncology Group (BGOG) and the Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (I.V.), BGOG and the Department of Medical Oncology and Hematology, AZ Maria Middelares, Ghent (C.V.), and the Department of Molecular Imaging, Pathology, Radiotherapy, and Oncology, Center for Oncological Research, Antwerp University, Antwerp (C.V.) - all in Belgium; the Nordic Society of Gynecologic Oncology (NSGO) and the Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.), NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), and NSGO and the Department of Oncology, Aalborg University, Aalborg (B.L.) - all in Denmark; GOG and Gynecologic Oncology, Medical University of South Carolina, Charleston (W.G.); GOG and Legacy Medical Group Gynecologic Oncology, Portland, OR (C.M.); Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Fondazione IRCCS National Cancer Institute of Milan (D.L.), and MITO and the Department of Obstetrics and Gynecology, San Raffaele Scientific Institute (G.M.) - both in Milan; USOR and the Department of Medical Oncology, BC Cancer, Vancouver, BC (P.H.), and GOG and the Department of Obstetrics and Gynecology, McGill University, and the Department of Oncology, McGill University Health Centre, Division of Gynecologic Oncology, Montreal (K.J.) - all in Canada; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Service d'Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France (G.F.); Arbeitsgemeinschaft Gynäkologische Onkologie and the Department of Gynecology and Obstetrics, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany (K.B.); the Division of Gynecologic Oncology, Ohio State University, Columbus (F.B.); GOG and the Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia (A.F.H.), and GOG and Hanjani Institute for Gynecologic Oncology, Asplundh Cancer Pavilion, Abington Jefferson Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Willow Grove (M.S.S.) - all in Pennsylvania; GOG and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee (W.H.B.); Israeli Society of Gynecologic Oncology and Department of Gynecology and Gynecologic Oncology, Hillel Yaffe Medical Center, Technion Israel Institute of Technology, Haifa, Israel (I.B.); GlaxoSmithKline/Tesaro, Waltham, MA (K.S., I.A.M., Y.L., D.G.); and Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix (B.J.M.)
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23
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Matulonis UA, Walder L, Nøttrup TJ, Bessette P, Mahner S, Gil-Martin M, Kalbacher E, Ledermann JA, Wenham RM, Woie K, Lau S, Marmé F, Casado Herraez A, Hardy-Bessard AC, Banerjee S, Lindahl G, Benigno B, Buscema J, Travers K, Guy H, Mirza MR. Niraparib Maintenance Treatment Improves Time Without Symptoms or Toxicity (TWiST) Versus Routine Surveillance in Recurrent Ovarian Cancer: A TWiST Analysis of the ENGOT-OV16/NOVA Trial. J Clin Oncol 2019; 37:3183-3191. [PMID: 31518175 PMCID: PMC6881097 DOI: 10.1200/jco.19.00917] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study estimated time without symptoms or toxicity (TWiST) with niraparib compared with routine surveillance (RS) in the maintenance treatment of patients with recurrent ovarian cancer. PATIENTS AND METHODS Mean progression-free survival (PFS) was estimated for niraparib and RS by fitting parametric survival distributions to Kaplan-Meier data for 553 patients with recurrent ovarian cancer who were enrolled in the phase III ENGOT-OV16/NOVA trial. Patients were categorized according to the presence or absence of a germline BRCA mutation—gBRCAmut and non-gBRCAmut cohorts. Mean time with toxicity was estimated based on the area under the Kaplan-Meier curve for symptomatic grade 2 or greater fatigue, nausea, and vomiting adverse events (AEs). Time with toxicity was the number of days a patient experienced an AE post–random assignment and before disease progression. TWiST was estimated as the difference between mean PFS and time with toxicity. Uncertainty was explored using alternative PFS estimates and considering all symptomatic grade 2 or greater AEs. RESULTS In the gBRCAmut and non-gBRCAmut cohorts, niraparib treatment resulted in a mean PFS benefit of 3.23 years and 1.44 years, respectively, and a mean time with toxicity of 0.28 years and 0.10 years, respectively, compared with RS. Hence, niraparib treatment resulted in a mean TWiST benefit of 2.95 years and 1.34 years, respectively, compared with RS, which is equivalent to more than four-fold and two-fold increases in mean TWiST between niraparib and RS in the gBRCAmut and non-gBRCAmut cohorts, respectively. This TWiST benefit was consistent across all sensitivity analyses, including modeling PFS over 5-, 10-, and 15-year time horizons. CONCLUSION Patients who were treated with niraparib compared with RS experienced increased mean TWiST. Thus, patients who were treated with niraparib in the ENGOT-OV16/NOVA trial experienced more time without symptoms or symptomatic toxicities compared with control.
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Affiliation(s)
| | | | - Trine J Nøttrup
- Nordic Society of Gynaecological Oncology and Copenhagen University Hospital, Copenhagen, Denmark
| | - Paul Bessette
- PMHC and University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Sven Mahner
- Arbeitsgemeinschaft Gynäkologische Onkologie and University of Munich, Munich, Germany
| | - Marta Gil-Martin
- Grupo Español de Investigación en Cáncer de Ovario and Institut Català d'Oncologia-IDIBELL, L'Hospitalet, Barcelona, Spain
| | - Elsa Kalbacher
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and University Hospital Besançon, Besançon, France
| | - Jonathan A Ledermann
- National Cancer Research Institute and University College London Cancer Institute, London, United Kingdom
| | | | - Kathrine Woie
- Nordic Society of Gynaecological Oncology and Haukeland University Hospital, Bergen, Norway
| | - Susie Lau
- PMHC and Jewish General Hospital, Montreal, Québec, Canada
| | - Frederik Marmé
- Arbeitsgemeinschaft Gynäkologische Onkologie and Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Antonio Casado Herraez
- Grupo Español de Investigación en Cáncer de Ovario and Hospital Universitario San Carlos, Madrid, Spain
| | - Anne-Claire Hardy-Bessard
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Centre Amoricain D'Oncologie, Paris, France
| | - Susana Banerjee
- National Cancer Research Institute and The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, United Kingdom
| | - Gabriel Lindahl
- Nordic Society of Gynaecological Oncology and Linköping University Hospital, Linköping, Sweden
| | | | | | | | - Holly Guy
- FIECON, Ltd, St Albans, United Kingdom
| | - Mansoor R Mirza
- Nordic Society of Gynaecological Oncology and Copenhagen University Hospital, Copenhagen, Denmark
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24
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Ray-Coquard I, Cibula D, Mirza MR, Reuss A, Ricci C, Colombo N, Koch H, Goffin F, González-Martin A, Ottevanger PB, Baumann K, Bjørge L, Lesoin A, Burges A, Rosenberg P, Gropp-Meier M, Harrela M, Harter P, Frenel JS, Minarik T, Pisano C, Hasenburg A, Merger M, du Bois A. Final results from GCIG/ENGOT/AGO-OVAR 12, a randomised placebo-controlled phase III trial of nintedanib combined with chemotherapy for newly diagnosed advanced ovarian cancer. Int J Cancer 2019; 146:439-448. [PMID: 31381147 DOI: 10.1002/ijc.32606] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/10/2019] [Accepted: 06/24/2019] [Indexed: 01/29/2023]
Abstract
AGO-OVAR 12 investigated the effect of adding the oral triple angiokinase inhibitor nintedanib to standard front-line chemotherapy for advanced ovarian cancer. At the primary analysis, nintedanib demonstrated significantly improved progression-free survival (PFS; primary endpoint) compared with placebo. We report final results, including overall survival (OS). Patients with primary debulked International Federation of Gynaecology and Obstetrics (FIGO) stage IIB-IV newly diagnosed ovarian cancer were randomised 2:1 to receive carboplatin (area under the curve 5 or 6) plus paclitaxel (175 mg/m2 ) on day 1 every 3 weeks for six cycles combined with either nintedanib 200 mg or placebo twice daily on days 2-21 every 3 weeks for up to 120 weeks. Between December 2009 and July 2011, 1,366 patients were randomised (911 to nintedanib, 455 to placebo). Disease was considered as high risk (FIGO stage III with >1 cm residuum, or any stage IV) in 39%. At the final analysis, 605 patients (44%) had died. There was no difference in OS (hazard ratio 0.99, 95% confidence interval [CI] 0.83-1.17, p = 0.86; median 62.0 months with nintedanib vs. 62.8 months with placebo). Subgroup analyses according to stratification factors, clinical characteristics and risk status showed no OS difference between treatments. The previously reported PFS improvement seen with nintedanib did not translate into an OS benefit in the nonhigh-risk subgroup. Updated PFS results were consistent with the primary analysis (hazard ratio 0.86, 95% CI 0.75-0.98; p = 0.029) favouring nintedanib. The safety profile was consistent with previous reports.
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Affiliation(s)
- Isabelle Ray-Coquard
- GINECO and Medical Oncology Department, Centre Léon Bérard, University Claude Bernard Lyon, Lyon, France
| | - David Cibula
- AGO and Oncogynecologic Center, Department of Obstetrics and Gynecology, General Faculty Hospital, Charles University of Prague, Prague, Czech Republic
| | - Mansoor R Mirza
- NSGO and Department of Oncology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - Alexander Reuss
- AGO and Coordinating Center for Clinical Trials, Philipps-University of Marburg, Marburg, Germany
| | - Caterina Ricci
- MITO and Division of Gynecologic Oncology, Department of Women and Children's Health and Public Health, Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | - Nicoletta Colombo
- MaNGO and European Institute of Oncology and University of Milan Bicocca, Milan, Italy
| | - Horst Koch
- AGO Austria and Department of Obstetrics and Gynecology, Paracelsus Medical University, Salzburg, Austria
| | | | | | - Petronella B Ottevanger
- DGOG and Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Klaus Baumann
- AGO and Department of Gynecology, Klinikum der Stadt Ludwigshafen GmbH, Ludwigshafen, Germany
| | - Line Bjørge
- NSGO and Department of Gynecology, Haukeland Universitetssykehus, Bergen, Norway.,Center for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Anne Lesoin
- GINECO and Department of Gynecologic Cancer and Medical Oncology, Centre Oscar Lambret, Lille, France
| | - Alexander Burges
- AGO and Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Germany
| | - Per Rosenberg
- NSGO and Department of Oncology, University Hospital Linköping, Linköping, Sweden
| | - Martina Gropp-Meier
- AGO and Department of Gynecology and Obstetrics, Oberschwabenklinik, Krankenhaus St. Elisabeth, Ravensburg, Germany
| | - Maija Harrela
- NSGO and Department of Gynoncology and Gynecology and Obstetrics, Kymenlaakso Central Hospital, Kotka, Finland
| | - Philipp Harter
- AGO and Department of Gynecology and Gynecologic Oncology, Kliniken Essen Mitte, Essen, Germany
| | - Jean-Sébastien Frenel
- GINECO and Centre René Gauducheau, Institut de Cancerologie de l'Ouest, Saint Herblain, France
| | - Tomas Minarik
- NSGO and National Institute of Oncology, Bratislava, Slovakia
| | - Carmela Pisano
- MITO and Department of Uro-Gynecologic Oncology, Istituto Nazionale per Io Studio e la Cura dei Tumori 'Fondazione G. Pascale' IRCCS, Naples, Italy
| | - Annette Hasenburg
- AGO and Department of Obstetrics and Gynecology, University Medical Center, Mainz, Germany
| | - Michael Merger
- Oncology Medicine, Boehringer Ingelheim International GmbH, Biberach, Germany
| | - Andreas du Bois
- AGO and Department of Gynecology and Gynecologic Oncology, Kliniken Essen Mitte, Essen, Germany
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25
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Lorusso D, Hilpert F, González Martin A, Rau J, Ottevanger P, Greimel E, Lück HJ, Selle F, Colombo N, Kroep JR, Mirza MR, Berger R, Pardo B, Grischke EM, Berton-Rigaud D, Martinez-Garcia J, Vergote I, Redondo A, Cardona A, Bastière-Truchot L, du Bois A, Kurzeder C. Patient-reported outcomes and final overall survival results from the randomized phase 3 PENELOPE trial evaluating pertuzumab in low tumor human epidermal growth factor receptor 3 (HER3) mRNA-expressing platinum-resistant ovarian cancer. Int J Gynecol Cancer 2019; 29:1141-1147. [PMID: 31420414 DOI: 10.1136/ijgc-2019-000370] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 05/15/2019] [Accepted: 05/29/2019] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The PENELOPE trial evaluated pertuzumab added to chemotherapy for biomarker-selected platinum-resistant ovarian cancer. As previously reported, pertuzumab did not statistically significantly improve progression-free survival (primary end point: HR 0.74, 95% CI 0.50 to 1.11), although results in the paclitaxel and gemcitabine cohorts suggested activity. Here, we report final overall survival and patient-reported outcomes. PATIENTS AND METHODS Eligible patients had ovarian carcinoma that progressed during/within 6 months of completing ≥4 platinum cycles, low tumor human epidermal growth factor receptor 3 (HER3) mRNA expression, and ≤2 prior chemotherapy lines. Investigators selected single-agent topotecan, gemcitabine or weekly paclitaxel before patients were randomized to either placebo or pertuzumab (840→420 mg every 3 weeks), stratified by selected chemotherapy, prior anti-angiogenic therapy, and platinum-free interval. Final overall survival analysis (key secondary end point) was pre-specified after 129 deaths. Patient-reported outcomes (secondary end point) were assessed at baseline and every 9 weeks until disease progression. RESULTS At database lock (June 9, 2016), 130 (83%) of 156 randomized patients had died. Median follow-up was 27 months in the pertuzumab arm versus 26 months in the control arm. In the intent-to-treat population there was no overall survival difference between treatment arms (stratified HR 0.90, 95% CI 0.61 to 1.32; p=0.60). Results in subgroups defined by stratification factors indicated heterogeneity similar to previous progression-free survival results. Updated safety was similar to previously published results. Compliance with patient-reported outcomes questionnaire completion was >75% for all validated patient-reported outcomes measures. Pertuzumab demonstrated neither beneficial nor detrimental effects on patient-reported outcomes compared with placebo, except for increased diarrhea symptoms. DISCUSSION Consistent with the primary results, adding pertuzumab to chemotherapy for low tumor HER3 mRNA-expressing platinum-resistant ovarian cancer did not improve overall survival, but showed trends in some cohorts. Except for increased diarrhea symptoms, pertuzumab had no impact on patient-reported outcomes. ClinicalTrials.gov: ClinicalTrials.gov: NCT01684878.
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Affiliation(s)
- Domenica Lorusso
- Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Felix Hilpert
- Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and Klinik für Gynäkologie und Geburtshilfe, Kiel, Germany (affiliation when work was performed).,Mammazentrum am Krankenhaus Jerusalem, Hamburg, Germany
| | - Antonio González Martin
- Grupo Español de Investigación en Cáncer de Ovario (GEICO) and MD Anderson Cancer Center Spain, Madrid, Spain (affiliation when work was performed).,Clínica Universidad de Navarra, Madrid, Spain
| | - Joern Rau
- Coordinating Center for Clinical Trials, Philipps-University of Marburg, Marburg, Germany
| | - Petronella Ottevanger
- Dutch Gynaecological Oncology Group (DGOG) and Department of Medical Oncology, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Hans-Joachim Lück
- AGO and Gynäkologisch-Onkologische Praxis am Pelikanplatz, Hannover, Germany
| | - Frédéric Selle
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Groupe Hospitalier Diaconesses Croix Saint-Simon and Alliance Pour la Recherche en Cancérologie, Paris, France
| | - Nicoletta Colombo
- Mario Negri Gynecologic Oncology (MaNGO) group, IEO, European Institute of Oncology IRCCS, and University of Milan-Bicocca, Milan, Italy
| | - Judith R Kroep
- DGOG and Department of Medical Oncology, Leids Universitair Medisch Centrum, Leiden, Netherlands
| | - Mansoor R Mirza
- Nordic Society of Gynaecological Oncology (NSGO) and Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Regina Berger
- AGO-Austria and University Hospital for Gynaecology and Obstetrics, Medical University of Innsbruck, Innsbruck, Austria
| | - Beatriz Pardo
- GEICO and Medical Oncology Department, Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain
| | - Eva-Maria Grischke
- AGO and University Hospital of Gynecology and Obstetrics, Tübingen, Germany
| | | | - Jeronimo Martinez-Garcia
- GEICO and Medical Oncology Service, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Spain
| | - Ignace Vergote
- AGO and Leuven Cancer Institute, University Hospital Leuven, Leuven, Belgium
| | - Andrés Redondo
- GEICO and Medical Oncology Department, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
| | | | | | | | - Christian Kurzeder
- AGO and Kliniken Essen Mitte, Essen, Germany.,Department of Gynecology and Gynecological Oncology, University Hospital Basel, University of Basel, Basel, Switzerland
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26
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Del Campo JM, Matulonis UA, Malander S, Provencher D, Mahner S, Follana P, Waters J, Berek JS, Woie K, Oza AM, Canzler U, Gil-Martin M, Lesoin A, Monk BJ, Lund B, Gilbert L, Wenham RM, Benigno B, Arora S, Hazard SJ, Mirza MR. Niraparib Maintenance Therapy in Patients With Recurrent Ovarian Cancer After a Partial Response to the Last Platinum-Based Chemotherapy in the ENGOT-OV16/NOVA Trial. J Clin Oncol 2019; 37:2968-2973. [PMID: 31173551 PMCID: PMC6839909 DOI: 10.1200/jco.18.02238] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE In the ENGOT-OV16/NOVA trial (ClinicalTrials.gov identifier: NCT01847274), maintenance therapy with niraparib, a poly(ADP-ribose) polymerase inhibitor, prolonged progression-free survival in patients with platinum-sensitive, recurrent ovarian cancer who had a response to their last platinum-based chemotherapy. The objective of the study was to assess the clinical benefit and patient-reported outcomes in patients who had a partial response (PR) and complete response (CR) to their last platinum-based therapy. PATIENTS AND METHODS A total of 553 patients were enrolled in the trial. Of 203 patients with a germline BRCA mutation (gBRCAmut), 99 had a PR and 104 had a CR to their last platinum-based therapy; of 350 patients without a confirmed gBRCAmut (non–gBRCAmut), 173 had a PR and 177 had a CR. Post hoc analyses were carried out to evaluate safety and the risk of progression in these patients according to gBRCAmut status and response to their last platinum-based therapy. Ovarian cancer–specific symptoms and quality of life were assessed using the Functional Assessment of Cancer Therapy–Ovarian Symptom Index. RESULTS Progression-free survival was improved in patients treated with niraparib compared with placebo in both the gBRCAmut cohort (PR: hazard ratio [HR], 0.24; 95% CI, 0.131 to 0.441; P < .0001; CR: HR, 0.30; 95% CI, 0.160 to 0.546; P < .0001) and the non–gBRCAmut cohort (PR: HR, 0.35; 95% CI, 0.230 to 0.532; P < .0001; CR: HR, 0.58; 95% CI, 0.383 to 0.868; P = .0082). The incidence of any-grade and grade 3 or greater adverse events was manageable. No meaningful differences were observed between niraparib and placebo in PR and CR subgroups with respect to patient-reported outcomes. CONCLUSION Patients achieved clinical benefit from maintenance treatment with niraparib regardless of response to the last platinum-based therapy.
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Affiliation(s)
- Josep M Del Campo
- Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Vall d'Hebrón University Hospital, Barcelona, Spain
| | | | - Susanne Malander
- Nordic Society of Gynaecological Oncology (NSGO) and Lund University Hospital, Lund, Sweden
| | - Diane Provencher
- Centre Hospitalier de L'Université de Montréal, Montreal, Quebec, Canada
| | - Sven Mahner
- Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Philippe Follana
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO) and Centre Antoine Lacassagne, Nice, France
| | - Justin Waters
- National Cancer Research Institute (NCRI) and Kent Oncology Centre, Maidstone Hospital, Kent, United Kingdom
| | - Jonathan S Berek
- Stanford Women's Cancer Center, Stanford Cancer Institute, Stanford, CA
| | | | - Amit M Oza
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Ulrich Canzler
- AGO and Technische Universität Dresden, Dresden, Germany
| | - Marta Gil-Martin
- GEICO and Institut Català d'Oncologia-IDIBELL, L'Hospitalet, Barcelona, Spain
| | - Anne Lesoin
- GINECO and Centre Oscar Lambret, Lille, France
| | - Bradley J Monk
- Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine at St Joseph's Hospital, Phoenix, AZ
| | - Bente Lund
- NSGO and Aalborg University Hospital, Aalborg, Denmark
| | - Lucy Gilbert
- McGill University, Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Robert M Wenham
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | | | | | - Mansoor R Mirza
- NSGO and Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark
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Berek JS, Matulonis UA, Peen U, Ghatage P, Mahner S, Redondo A, Lesoin A, Colombo N, Vergote I, Rosengarten O, Ledermann J, Pineda M, Ellard S, Sehouli J, Gonzalez-Martin A, Berton-Rigaud D, Madry R, Reinthaller A, Hazard S, Guo W, Mirza MR. Safety and dose modification for patients receiving niraparib. Ann Oncol 2019; 30:859. [PMID: 30107447 DOI: 10.1093/annonc/mdy255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
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Fabbro M, Moore KN, Dørum A, Tinker AV, Mahner S, Bover I, Banerjee S, Tognon G, Goffin F, Shapira-Frommer R, Wenham RM, Hellman K, Provencher D, Harter P, Vázquez IP, Follana P, Pineda MJ, Mirza MR, Hazard SJ, Matulonis UA. Efficacy and safety of niraparib as maintenance treatment in older patients (≥ 70 years) with recurrent ovarian cancer: Results from the ENGOT-OV16/NOVA trial. Gynecol Oncol 2019; 152:560-567. [PMID: 30638768 DOI: 10.1016/j.ygyno.2018.12.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 12/04/2018] [Accepted: 12/07/2018] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To analyze the safety and efficacy of niraparib in patients aged ≥70 years with recurrent ovarian cancer in the ENGOT-OV16/NOVA trial. METHODS The trial enrolled 2 independent cohorts with histologically diagnosed recurrent ovarian, fallopian tube, or peritoneal cancer who responded to platinum rechallenge, on the basis of germline breast cancer susceptibility gene mutation (gBRCAmut) status. Patients were randomized 2:1 to receive niraparib (300 mg) or placebo once daily until disease progression. The primary endpoint was progression-free survival (PFS) by blinded independent central review. Adverse events (AEs) of special interest were based on the known safety profile of poly(ADP-ribose) polymerase inhibitors. RESULTS Patients aged ≥70 years in the gBRCAmut cohort receiving niraparib (n = 14) had not yet reached a median PFS compared with a median PFS of 3.7 months for the same age group in the placebo arm (hazard ratio [HR], 0.09 [95% confidence interval (CI), 0.01 to 0.73]). Non-gBRCAmut patients aged ≥70 years receiving niraparib (n = 47) had a median PFS of 11.3 months compared with 3.8 months in the placebo arm (HR, 0.35 [95% CI, 0.18 to 0.71]). Median duration of follow-up in the niraparib arm was 17.3 months in patients ≥70 years and 17.2 months in patients <70 years. Frequency, severity of AEs, and dose reductions in the niraparib arm were similar in patients aged <70 and ≥ 70 years population. The most common grade ≥ 3 AEs in patients ≥70 years were hematologic: thrombocytopenia event (34.4%), anemia event (13.1%), and neutropenia event (16.4%). CONCLUSIONS For patients ≥70 years of age receiving niraparib as maintenance treatment in the ENGOT-OV16/NOVA trial, PFS benefits and incidence of any grade or serious treatment-emergent AEs were comparable to results in the younger population. Use of niraparib should be considered in this population.
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Affiliation(s)
- Michel Fabbro
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Paris, France; Institut du Cancer de Montpellier, Montpellier, France.
| | - Kathleen N Moore
- Stephenson Cancer Center, University of Oklahoma HSC, Oklahoma City, OK, USA; Sarah Cannon Research Institute, Nashville, TN, USA
| | - Anne Dørum
- Nordic Society of Gynaecological Oncology (NSGO), Copenhagen, Denmark; Radiumhospitalet, Oslo University Hospital, Oslo, Norway
| | | | - Sven Mahner
- Arbeitsgemeinschaft Gynäkologische Onkologie (AGO), Taufkirchen, Germany; Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Obstetrics and Gynecology, University Hospital Munich, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Isabel Bover
- Grupo Español de Investigación en Cáncer de Ovario (GEICO), Madrid, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - Susana Banerjee
- National Cancer Research Institute (NCRI), London, United Kingdom; The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Germana Tognon
- Division of Obstetrics and Gynecology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Frederic Goffin
- Belgium and Luxembourg Gynaecological Oncology Group (BGOG), Liège, Belgium; University of Liège, CHU de Liège, Site Hôpital de la Citadelle, Liège, Belgium
| | - Ronnie Shapira-Frommer
- Israeli Society of Gynecologic Oncology (ISGO), Hadera, Israel; Sheba Medical Center, Ramat Gan, Israel
| | - Robert M Wenham
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Kristina Hellman
- Nordic Society of Gynaecological Oncology (NSGO), Copenhagen, Denmark; Karolinska University Hospital, Stockholm, Sweden
| | - Diane Provencher
- Centre Hospitalier de L'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Philipp Harter
- Arbeitsgemeinschaft Gynäkologische Onkologie (AGO), Taufkirchen, Germany; Department of Gynecology & Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - Isabel Palacio Vázquez
- Grupo Español de Investigación en Cáncer de Ovario (GEICO), Madrid, Spain; Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Philippe Follana
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Paris, France; Centre Antoine Lacassagne, Nice, France
| | | | - Mansoor R Mirza
- Nordic Society of Gynaecological Oncology (NSGO), Copenhagen, Denmark; Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark
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Trillsch F, du Bois A, Sehouli J, Canzler U, Marmé F, Hilpert F, Lück HJ, Meier W, Emons G, Heubner ML, Harter P, Reinthaller A, Mirza MR, Oza A, Mahner S. Lebensqualität unter Niraparib-Erhaltungstherapie bei Patientinnen mit rezidiviertem Ovarialkarzinom: Ergebnisse der AGO-OVAR 2.22-Studie (ENGOT-OV16/NOVA). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- F Trillsch
- Klinikum der Universität München, LMU München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, München, Deutschland
| | - A du Bois
- Kliniken Essen-Mitte (KEM), Evang. Huyssens-Stiftung/Knappschaft GmbH, Klinik für Gynäkologie und gynäkologische Onkologie, Essen, Deutschland
| | - J Sehouli
- Universitätsmedizin Berlin Charité, Campus Virchow Klinikum, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin, Deutschland
| | - U Canzler
- Universitätsklinikum Carl Gustav Carus Dresden an der Technischen Universität Dresden, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Dresden, Deutschland
| | - F Marmé
- Nationales Centrum für Tumorerkrankungen, Universitätsfrauenklinik, Heidelberg, Deutschland
| | - F Hilpert
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Gynäkologie und Geburtshilfe, Kiel, Deutschland
- Onkologisches Therapiezentrum am Krankenhaus Jerusalem, Hamburg, Deutschland
| | - HJ Lück
- Gynäkologisch-Onkologische Praxis am Pelikanplatz, Hannover, Deutschland
| | - W Meier
- Evangelisches Krankenhaus, Frauenklinik, Düsseldorf, Deutschland
| | - G Emons
- Universitätsmedizin Göttingen, Klinik für Gynäkologie und Geburtshilfe, Göttingen, Deutschland
| | - ML Heubner
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Essen, Deutschland
- Kantonsspital Baden AG, Department Frauen und Kinder, Baden, Schweiz
| | - P Harter
- Kliniken Essen-Mitte (KEM), Evang. Huyssens-Stiftung/Knappschaft GmbH, Klinik für Gynäkologie und gynäkologische Onkologie, Essen, Deutschland
| | - A Reinthaller
- Universitätsfrauenklinik Wien, Abteilung für Allgemeine Gynäkologie und Gynäkologische Onkologie, Wien, Österreich
| | - MR Mirza
- Ringshospitalet – Copenhagen University Hospital, Department of Oncology, Kopenhagen, Dänemark
| | - A Oza
- Princess Margaret Cancer Centre, Toronto, Kanada
| | - S Mahner
- Klinikum der Universität München, LMU München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, München, Deutschland
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Marmé F, du Bois A, Sehouli J, Canzler U, Hilpert F, Lück HJ, Meier W, Emons G, Heubner ML, Wölber L, Harter P, Marth C, Mirza MR, Mahner S. Sicherheit und Wirksamkeit von Niraparib bei älteren Patientinnen mit rezidiviertem Ovarialkarzinom: eine Subgruppenanalyse der AGO Ovar 2.22 (ENGOT-OV16/NOVA) Phase III Studie. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- F Marmé
- Universitärtsklinikum Heidelberg, Nationales Centrum für TUmorerkrankungen; Sektion Gynäkologische Onkologie, Heidelberg, Deutschland
| | - A du Bois
- Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Klinik für Gynäkologie und gynäkologische Onkologie, Essen, Deutschland
| | - J Sehouli
- Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin, Deutschland
| | - U Canzler
- Universitätsklinikum Carl Gustav Carus Dresden an der Technischen Universität Dresden, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Dresden, Deutschland
| | - F Hilpert
- Universitätklinikum Schleswig-Holstein, Campus Kiel, Klinik für Gynäkologie und Geburtshilfe, Kiel, Deutschland
- Onkologisches Therapiezentrum Krankenhaus Jerusalem, Hamburg, Deutschland
| | - HJ Lück
- Gynäkologisch-Onkologische Praxis am Pelikanplatz, Hannover, Germany, Hannover, Deutschland
| | - W Meier
- Universitätsfrauenklinik Düsseldorf, Düsseldorf, Deutschland
| | - G Emons
- Universitätsmedizin Göttingen, Klinik für Gynäkologie und Geburtshilfe, Göttingen, Deutschland
| | - ML Heubner
- Kliniken Essen-Mitte (KEM), Evang. Huyssens-Stiftung/Knappschaft GmbH, Klinik für Gynäkologie und gynäkologische Onkologie, Essen, Deutschland
- Kantonsspital Baden AG, Department Frauen und Kinder, Baden, Schweiz
| | - L Wölber
- Universitätklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynäkologie, Hamburg, Deutschland
| | - P Harter
- Kliniken Essen-Mitte (KEM), Evang. Huyssens-Stiftung/Knappschaft GmbH, Klinik für Gynäkologie und gynäkologische Onkologie, Essen, Deutschland
| | - C Marth
- Medizinische Universität Innsbruck, Univ. Klinik für Frauenheilkunde, Innsbruck, Österreich
| | - MR Mirza
- Ringshospitalet – Copenhagen University Hospital, Department of Oncology, Copenhagen, Dänemark
| | - S Mahner
- Klinikum der Universität München, LMU, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, München, Deutschland
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Chang H, Kashyap T, Debler S, Unger TJ, Wang S, Mikule K, Wang J, Mirza MR, Shacham S, Landesman Y. Abstract 5826: Enhanced anti-tumor effects of selinexor and niraparib in preclinical models of ovarian cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-5826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Selinexor (KPT-330) is a first-in-class oral exportin-1 (XPO1/ CRM1) inhibitor that induces cell cycle arrest and apoptosis in cancer cells through reactivation of tumor suppressor proteins and inhibition of DNA damage repair genes. Here, we studied selinexor in combination with niraparib, an inhibitor of the DNA damage repair proteins PARP1 and 2, in preclinical models of ovarian cancer. Given that both compounds can inhibit DNA damage repair responses, we hypothesized the combination of selinexor and niraparib would enhance cancer cell death by accumulation of DNA damage that cannot be resolved in ovarian cancer.
Methods: Selinexor and niraparib alone and in combination were tested in vitro on the BRCA wildtype ovarian cancer cell line A2780. Total RNA and protein were extracted from cell lysates and analyzed by qPCR and immunoblots. In vivo, a subcutaneous A2780 xenograft mouse model was treated with selinexor [10 mg/kg, once per week (M) for three weeks] or niraparib [37.5 mg/kg, once-daily for five days per week (M-F) for three weeks] as single agents or in combination. Tumor growth and body weights were measured for 21 days. Tumors were harvested at the end of the study and analyzed by immunohistochemistry (IHC).
Results: Selinexor and niraparib as single agents inhibited A2780 cell proliferation (selinexor IC50: 200nM; niraparib IC50: 800nM). The combination of selinexor and niraparib showed synergistic cytotoxicity in A2780 cells. Increased expression of phospho (S139) H2A.X with the combination confirmed induction of DNA damage. In vivo, the combination enhanced tumor inhibition (51.0% in combination versus 24.3% and 29.6% in selinexor and niraparib respectively) and improved median survival compared to vehicle or each agent alone (18 days in combination group versus 11, 14 and 16 days in vehicle, selinexor, and niraparib groups, respectively). IHC analysis showed enhanced nuclear p53 and p21 staining in selinexor treated tumors as well as in tumors treated with the combination. Increased apoptosis was observed in tumor samples treated with both selinexor and niraparib as compared to vehicle control or each agent alone.
Conclusions: Selinexor plus niraparib demonstrated enhanced anti-tumor activity in preclinical models of human ovarian cancer. Since both drugs could inhibit DNA damage repair pathway, the drug combination efficiently accumulated DNA damage, which was associated with reduced cell proliferation, and induced apoptosis. This combination therapy warrants further investigation as a treatment option for patients with ovarian cancer.
Citation Format: Hua Chang, Trinayan Kashyap, Sophie Debler, Thaddeus J. Unger, Sarah Wang, Keith Mikule, Jing Wang, Mansoor R. Mirza, Sharon Shacham, Yosef Landesman. Enhanced anti-tumor effects of selinexor and niraparib in preclinical models of ovarian cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5826.
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Affiliation(s)
- Hua Chang
- 1Karyopharm Therapeutics, Inc., Newton, MA
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Zubair M, Habib L, Yousuf M, Ghazanfar S, Quraishi S, Quraishi MS, Mirza MR. Audit of Laparoscopic Cholecystectomy: Impact of Procedure Recording on Clinical Practice. Mymensingh Med J 2018; 27:645-649. [PMID: 30141458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Recorded videos of laparoscopic surgery can be used to audit surgical practice with a view to improve clinical practice and surgical outcomes. The objective was to audit our own practice by reviewing video recordings of laparoscopic cholecystectomies to improve our dissection in Calot's triangle and to prevent gall bladder perforation. We used recorded videos of laparoscopic cholecystectomy. In this study initially one hundred consecutive videos were reviewed for: a) establishment of critical view of safety, b) optimization of critical view of safety by division of cystic artery before cystic duct, c) perforation of gall bladder and d) use of diathermy for cystic artery. This prospective interventional audit was performed in a Civil Hospital, Karachi and Hamdard University Hospital, Karachi, Pakistan from January 2008 to March 2010. Recommendations were made according to published literature to change the practice in these steps of procedures. These recommendations were implemented in practice and the following 100 videos were reviewed for the same criteria to see the impact on clinical practice. In the first group, critical view of safety was established in 91 patients compared with 99 patients in 2nd group (p=0.009), optimization of view was done in 54 and 83 patients respectively (p<001), perforation occurred in 32 and 19 patients respectively (p=0.035) and use of diathermy for cystic artery, which was the routine, was stopped completely in the 2nd group. Audit of recorded videos of laparoscopic cholecystectomy can be used as an effective tool to improve surgical practice for safer and better outcome.
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Affiliation(s)
- M Zubair
- Dr Muhammad Zubair, Associate Professor, Surgical Unit IV, Department of Surgery, Dow University of Health Sciences & Civil Hospital, Karachi, Pakistan
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Bamias A, Gibbs E, Khoon Lee C, Davies L, Dimopoulos M, Zagouri F, Veillard AS, Kosse J, Santaballa A, Mirza MR, Tabaro G, Vergote I, Bloemendal H, Lykka M, Floquet A, Gebski V, Pujade-Lauraine E. Bevacizumab with or after chemotherapy for platinum-resistant recurrent ovarian cancer: exploratory analyses of the AURELIA trial. Ann Oncol 2018; 28:1842-1848. [PMID: 28481967 DOI: 10.1093/annonc/mdx228] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background In the open-label randomized phase III AURELIA trial, adding bevacizumab to chemotherapy for platinum-resistant ovarian cancer (PROC) significantly improved progression-free survival and response rate versus chemotherapy alone, but not overall survival (OS). We explored the effect of bevacizumab use after disease progression (PD) in patients randomized to chemotherapy alone. Patients and methods In AURELIA, 361 women with PROC were randomized to chemotherapy alone or with bevacizumab. Patients initially randomized to chemotherapy were offered bevacizumab after PD. Post hoc analyses assessed efficacy and safety in three subgroups: chemotherapy alone, chemotherapy followed by bevacizumab after PD, and chemotherapy plus bevacizumab at randomization. Results Of the 182 patients randomized to chemotherapy alone, 72 (40%) received bevacizumab after PD and 110 (60%) never received bevacizumab. There were no significant differences in patient and disease characteristics between these subgroups at baseline or the time of PD. Compared with patients never receiving bevacizumab, the risk of death was significantly reduced in patients receiving bevacizumab either upfront with chemotherapy [hazard ratio (HR) = 0.68, 95% confidence interval (CI) 0.52-0.90] or after PD (HR = 0.60, 95% CI 0.43-0.86). The tolerability of bevacizumab was similar with administration upfront or after PD. Conclusions Post-PD bevacizumab use may have confounded OS results in AURELIA. In these exploratory analyses of non-randomized subgroups, bevacizumab use, either with chemotherapy or after PD on chemotherapy alone, improved OS compared with no bevacizumab. Combining bevacizumab with chemotherapy at first appearance of platinum resistance maximises the likelihood of patients receiving this active treatment for PROC. ClinicalTrials.gov: NCT00976911.
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Affiliation(s)
- A Bamias
- HECOG and Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - E Gibbs
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - C Khoon Lee
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - L Davies
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - M Dimopoulos
- HECOG and Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - F Zagouri
- HECOG and Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - A-S Veillard
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - J Kosse
- AGO and Department of Gynaecology, Sana Klinikum Offenbach, Offenbach, Germany
| | - A Santaballa
- GEICO and Medical Oncology Department, University Hospital and Polytechnic, Valencia, Spain
| | - M R Mirza
- NSGO and Department of Oncology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - G Tabaro
- MITO and USCC/Dir. Scientifica, Centro di Riferimento Oncologico, CRO-IRCCS, Aviano, Italy
| | - I Vergote
- BGOG and Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, University Hospital Leuven, Leuven, Belgium
| | - H Bloemendal
- DGOG and Department of Internal Medicine/Oncology, Meander Medical Center, Amersfoort, The Netherlands
| | - M Lykka
- HECOG and Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - A Floquet
- GINECO and Medical Oncology and Genetics Department, Institut Bergonié, Bordeaux
| | - V Gebski
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - E Pujade-Lauraine
- GINECO and Paris Descartes University, AP-HP Central Paris University Hospitals, Paris, France
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Wilson MK, Pujade-Lauraine E, Aoki D, Mirza MR, Lorusso D, Oza AM, du Bois A, Vergote I, Reuss A, Bacon M, Friedlander M, Gallardo-Rincon D, Joly F, Chang SJ, Ferrero AM, Edmondson RJ, Wimberger P, Maenpaa J, Gaffney D, Zang R, Okamoto A, Stuart G, Ochiai K. Fifth Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup: recurrent disease. Ann Oncol 2017; 28:727-732. [PMID: 27993805 DOI: 10.1093/annonc/mdw663] [Citation(s) in RCA: 169] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 11/23/2016] [Indexed: 12/19/2022] Open
Abstract
This manuscript reports the consensus statements regarding recurrent ovarian cancer (ROC), reached at the fifth Ovarian Cancer Consensus Conference (OCCC), which was held in Tokyo, Japan, in November 2015. Three important questions were identified: (i) What are the subgroups for clinical trials in ROC? The historical definition of using platinum-free interval (PFI) to categorise patients as having platinum-sensitive/resistant disease was replaced by therapy-free interval (TFI). TFI can be broken down into TFIp (PFI), TFInp (non-PFI) and TFIb (biological agent-free interval). Additional criteria to consider include histology, BRCA mutation status, number/type of previous therapies, outcome of prior surgery and patient reported symptoms. (ii) What are the control arms for clinical trials in ROC? When platinum is considered the best option, the control arm should be a platinum-based therapy with or without an anti-angiogenic agent or a poly (ADP-ribose) polymerase (PARP) inhibitor. If platinum is not considered the best option, the control arm could include a non-platinum drug, either as single agent or in combination. (iii) What are the endpoints for clinical trials in ROC? Overall survival (OS) is the preferred endpoint for patient cohorts with an expected median OS < or = 12 months. Progression-free survival (PFS) is an alternative, and it is the preferred endpoint when the expected median OS is > 12 months. However, PFS alone should not be the only endpoint and must be supported by additional endpoints including pre-defined patient reported outcomes (PROs), time to second subsequent therapy (TSST), or time until definitive deterioration of quality of life (TUDD).
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Chen Y, Camacho SC, Silvers TR, Razak ARA, Gabrail NY, Gerecitano JF, Kalir E, Pereira E, Evans BR, Ramus SJ, Huang F, Priedigkeit N, Rodriguez E, Donovan M, Khan F, Kalir T, Sebra R, Uzilov A, Chen R, Sinha R, Halpert R, Billaud JN, Shacham S, McCauley D, Landesman Y, Rashal T, Kauffman M, Mirza MR, Mau-Sørensen M, Dottino P, Martignetti JA. Inhibition of the Nuclear Export Receptor XPO1 as a Therapeutic Target for Platinum-Resistant Ovarian Cancer. Clin Cancer Res 2017; 23:1552-1563. [PMID: 27649553 DOI: 10.1158/1078-0432.ccr-16-1333] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/10/2016] [Accepted: 08/25/2016] [Indexed: 11/16/2022]
Abstract
Purpose: The high fatality-to-case ratio of ovarian cancer is directly related to platinum resistance. Exportin-1 (XPO1) is a nuclear exporter that mediates nuclear export of multiple tumor suppressors. We investigated possible clinicopathologic correlations of XPO1 expression levels and evaluated the efficacy of XPO1 inhibition as a therapeutic strategy in platinum-sensitive and -resistant ovarian cancer.Experimental Design: XPO1 expression levels were analyzed to define clinicopathologic correlates using both TCGA/GEO datasets and tissue microarrays (TMA). The effect of XPO1 inhibition, using the small-molecule inhibitors KPT-185 and KPT-330 (selinexor) alone or in combination with a platinum agent on cell viability, apoptosis, and the transcriptome was tested in immortalized and patient-derived ovarian cancer cell lines (PDCL) and platinum-resistant mice (PDX). Seven patients with late-stage, recurrent, and heavily pretreated ovarian cancer were treated with an oral XPO1 inhibitor.Results: XPO1 RNA overexpression and protein nuclear localization were correlated with decreased survival and platinum resistance in ovarian cancer. Targeted XPO1 inhibition decreased cell viability and synergistically restored platinum sensitivity in both immortalized ovarian cancer cells and PDCL. The XPO1 inhibitor-mediated apoptosis occurred through both p53-dependent and p53-independent signaling pathways. Selinexor treatment, alone and in combination with platinum, markedly decreased tumor growth and prolonged survival in platinum-resistant PDX and mice. In selinexor-treated patients, tumor growth was halted in 3 of 5 patients, including one with a partial response, and was safely tolerated by all.Conclusions: Taken together, these results provide evidence that XPO1 inhibition represents a new therapeutic strategy for overcoming platinum resistance in women with ovarian cancer. Clin Cancer Res; 23(6); 1552-63. ©2016 AACR.
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Affiliation(s)
- Ying Chen
- Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Thomas R Silvers
- Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Albiruni R A Razak
- Drug Development Program, Princess Margaret Cancer Center, Toronto, Canada
| | | | | | - Eva Kalir
- Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Elena Pereira
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Brad R Evans
- Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Susan J Ramus
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Fei Huang
- Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nolan Priedigkeit
- Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Estefania Rodriguez
- Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Michael Donovan
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Faisal Khan
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Tamara Kalir
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert Sebra
- Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Andrew Uzilov
- Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Rong Chen
- Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Rileen Sinha
- Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | | | | | | | | | - Tami Rashal
- Karyopharm Therapeutics Inc, Natick, Massachusetts
| | | | | | | | - Peter Dottino
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - John A Martignetti
- Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
- Western Connecticut Health Network, Danbury, Connecticut
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Affiliation(s)
- Mansoor R Mirza
- Rigshospitalet–Copenhagen University Hospital, Copenhagen, Denmark.
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Abdul Razak AR, Mau-Soerensen M, Gabrail NY, Gerecitano JF, Shields AF, Unger TJ, Saint-Martin JR, Carlson R, Landesman Y, McCauley D, Rashal T, Lassen U, Kim R, Stayner LA, Mirza MR, Kauffman M, Shacham S, Mahipal A. First-in-Class, First-in-Human Phase I Study of Selinexor, a Selective Inhibitor of Nuclear Export, in Patients With Advanced Solid Tumors. J Clin Oncol 2016; 34:4142-4150. [PMID: 26926685 PMCID: PMC5562433 DOI: 10.1200/jco.2015.65.3949] [Citation(s) in RCA: 171] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose This trial evaluated the safety, pharmacokinetics, pharmacodynamics, and efficacy of selinexor (KPT-330), a novel, oral small-molecule inhibitor of exportin 1 (XPO1/CRM1), and determined the recommended phase II dose. Patients and Methods In total, 189 patients with advanced solid tumors received selinexor (3 to 85 mg/m2) in 21- or 28-day cycles. Pre- and post-treatment levels of XPO1 mRNA in patient-derived leukocytes were determined by reverse transcriptase quantitative polymerase chain reaction, and tumor biopsies were examined by immunohistochemistry for changes in markers consistent with XPO1 inhibition. Antitumor response was assessed according Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 guidelines. Results The most common treatment-related adverse events included fatigue (70%), nausea (70%), anorexia (66%), and vomiting (49%), which were generally grade 1 or 2. Most commonly reported grade 3 or 4 toxicities were thrombocytopenia (16%), fatigue (15%), and hyponatremia (13%). Clinically significant major organ or cumulative toxicities were rare. The maximum-tolerated dose was defined at 65 mg/m2 using a twice-a-week (days 1 and 3) dosing schedule. The recommended phase II dose of 35 mg/m2 given twice a week was chosen based on better patient tolerability and no demonstrable improvement in radiologic response or disease stabilization compared with higher doses. Pharmacokinetics were dose proportional, with no evidence of drug accumulation. Dose-dependent elevations in XPO1 mRNA in leukocytes were demonstrated up to a dose level of 28 mg/m2 before plateauing, and paired tumor biopsies showed nuclear accumulation of key tumor-suppressor proteins, reduction of cell proliferation, and induction of apoptosis. Among 157 patients evaluable for response, one complete and six partial responses were observed (n = 7, 4%), with 27 patients (17%) achieving stable disease for ≥ 4 months. Conclusion Selinexor is a novel and safe therapeutic with broad antitumor activity. Further interrogation into this class of therapy is warranted.
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Affiliation(s)
- Albiruni R. Abdul Razak
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Morten Mau-Soerensen
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Nashat Y. Gabrail
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - John F. Gerecitano
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Anthony F. Shields
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Thaddeus J. Unger
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Jean R. Saint-Martin
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Robert Carlson
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Yosef Landesman
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Dilara McCauley
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Tami Rashal
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Ulrik Lassen
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Richard Kim
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Lee-Anne Stayner
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Mansoor R. Mirza
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Michael Kauffman
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Sharon Shacham
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Amit Mahipal
- Albiruni R. Abdul Razak and Lee-Anne Stayner, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Morten Mau-Soerensen and Ulrik Lassen, Rigshospitalet, Copenhagen, Denmark; Nashat Y. Gabrail, Gabrail Cancer Institute, Canton, OH; John F. Gerecitano, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY; Anthony F. Shields, Karmanos Cancer Institute, Wayne State University, Detroit, MI; Thaddeus J. Unger, Jean R. Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Mansoor R. Mirza, Michael Kauffman, and Sharon Shacham, Karyopharm Therapeutics, Newton, MA; and Richard Kim and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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Mirza MR, Monk BJ, Herrstedt J, Oza AM, Mahner S, Redondo A, Fabbro M, Ledermann JA, Lorusso D, Vergote I, Ben-Baruch NE, Marth C, Mądry R, Christensen RD, Berek JS, Dørum A, Tinker AV, du Bois A, González-Martín A, Follana P, Benigno B, Rosenberg P, Gilbert L, Rimel BJ, Buscema J, Balser JP, Agarwal S, Matulonis UA. Niraparib Maintenance Therapy in Platinum-Sensitive, Recurrent Ovarian Cancer. N Engl J Med 2016; 375:2154-2164. [PMID: 27717299 DOI: 10.1056/nejmoa1611310] [Citation(s) in RCA: 1609] [Impact Index Per Article: 201.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Niraparib is an oral poly(adenosine diphosphate [ADP]-ribose) polymerase (PARP) 1/2 inhibitor that has shown clinical activity in patients with ovarian cancer. We sought to evaluate the efficacy of niraparib versus placebo as maintenance treatment for patients with platinum-sensitive, recurrent ovarian cancer. METHODS In this randomized, double-blind, phase 3 trial, patients were categorized according to the presence or absence of a germline BRCA mutation (gBRCA cohort and non-gBRCA cohort) and the type of non-gBRCA mutation and were randomly assigned in a 2:1 ratio to receive niraparib (300 mg) or placebo once daily. The primary end point was progression-free survival. RESULTS Of 553 enrolled patients, 203 were in the gBRCA cohort (with 138 assigned to niraparib and 65 to placebo), and 350 patients were in the non-gBRCA cohort (with 234 assigned to niraparib and 116 to placebo). Patients in the niraparib group had a significantly longer median duration of progression-free survival than did those in the placebo group, including 21.0 vs. 5.5 months in the gBRCA cohort (hazard ratio, 0.27; 95% confidence interval [CI], 0.17 to 0.41), as compared with 12.9 months vs. 3.8 months in the non-gBRCA cohort for patients who had tumors with homologous recombination deficiency (HRD) (hazard ratio, 0.38; 95% CI, 0.24 to 0.59) and 9.3 months vs. 3.9 months in the overall non-gBRCA cohort (hazard ratio, 0.45; 95% CI, 0.34 to 0.61; P<0.001 for all three comparisons). The most common grade 3 or 4 adverse events that were reported in the niraparib group were thrombocytopenia (in 33.8%), anemia (in 25.3%), and neutropenia (in 19.6%), which were managed with dose modifications. CONCLUSIONS Among patients with platinum-sensitive, recurrent ovarian cancer, the median duration of progression-free survival was significantly longer among those receiving niraparib than among those receiving placebo, regardless of the presence or absence of gBRCA mutations or HRD status, with moderate bone marrow toxicity. (Funded by Tesaro; ClinicalTrials.gov number, NCT01847274 .).
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Affiliation(s)
- Mansoor R Mirza
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Bradley J Monk
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Jørn Herrstedt
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Amit M Oza
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Sven Mahner
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Andrés Redondo
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Michel Fabbro
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Jonathan A Ledermann
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Domenica Lorusso
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Ignace Vergote
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Noa E Ben-Baruch
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Christian Marth
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Radosław Mądry
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - René D Christensen
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Jonathan S Berek
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Anne Dørum
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Anna V Tinker
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Andreas du Bois
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Antonio González-Martín
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Philippe Follana
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Benedict Benigno
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Per Rosenberg
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Lucy Gilbert
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Bobbie J Rimel
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Joseph Buscema
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - John P Balser
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Shefali Agarwal
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
| | - Ursula A Matulonis
- From the Nordic Society of Gynecological Oncology and Rigshospitalet-Copenhagen University Hospital, Copenhagen (M.R.M.), Odense University Hospital (J.H.) and European Network for Gynacological Oncological Trial and Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense (R.D.C.) - all in Denmark; University of Arizona and Creighton University-Phoenix, Phoenix (B.J.M.), and Arizona Oncology Associates, Tuscon (B.J.M., J.B.) - all in Arizona; Princess Margaret Consortium, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto (A.M.O.), British Columbia Cancer Agency, Vancouver (A.V.T.), and McGill University-McGill University Health Centre, Montreal (L.G.) - all in Canada; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and the University of Munich, Munich (S.M.), and Kliniken Essen Mitte, Essen (A.B.) - both in Germany; Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Hospital Universitario La Paz (A.R.), and GEICO and M.D. Anderson Cancer Center Madrid (A.G.-M.), Madrid; French Investigator Group for Ovarian and Breast Cancer (GINECO) and Institut du Cancer de Montpellier, Montpellier (M.F.), and GINECO and Centre Antoine Lacassagne, Nice (P.F.) - both in France; National Cancer Research Institute and UCL Cancer Institute, University College London, London (J.A.L.); Multicenter Italian Trials in Ovarian Cancer/Mario Negri Gynecologic Oncology Group, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan (D.L.); Belgium and Luxembourg Gynecological Oncology Group and University of Leuven, Leuven, Belgium (I.V.); Kaplan Medical Center, Rehovot, Israel (N.E.B.-B.); AGO-Austria and Medical University Innsbruck, Innsbruck, Austria (C.M.); Central and Eastern European Gynecologic Oncology Group and Uniwersytet Medyczny w Poznaniu, Poznan, Poland (R.M.); Stanford Comprehensive Cancer Institute, Stanford (J.S.B.), and Cedars-Sinai Medical Center, West Hollywood (B.J.R.) - both in California; Oslo University Hospital, Radiumhospitalet, Oslo (A.D.); Northside Hospital, Atlanta (B.B.); Universitetssjukhuset, Linköping, Sweden (P.R.); and Veristat, Southborough (J.P.B.), Tesaro, Waltham (S.A.), and Dana-Farber Cancer Institute, Boston (U.A.M.) - all in Massachusetts
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Pulford DJ, Harter P, Floquet A, Barrett C, Suh DH, Friedlander M, Arranz JA, Hasegawa K, Tada H, Vuylsteke P, Mirza MR, Donadello N, Scambia G, Johnson T, Cox C, Chan JK, Imhof M, Herzog TJ, Calvert P, Wimberger P, Berton-Rigaud D, Lim MC, Elser G, Xu CF, du Bois A. Communicating BRCA research results to patients enrolled in international clinical trials: lessons learnt from the AGO-OVAR 16 study. BMC Med Ethics 2016; 17:63. [PMID: 27769273 PMCID: PMC5073453 DOI: 10.1186/s12910-016-0144-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 10/07/2016] [Indexed: 01/15/2023] Open
Abstract
Background The focus on translational research in clinical trials has the potential to generate clinically relevant genetic data that could have importance to patients. This raises challenging questions about communicating relevant genetic research results to individual patients. Methods An exploratory pharmacogenetic analysis was conducted in the international ovarian cancer phase III trial, AGO-OVAR 16, which found that patients with clinically important germ-line BRCA1/2 mutations had improved progression-free survival prognosis. Mechanisms to communicate BRCA results were evaluated, because these findings may be beneficial to patients and their families. Results Communicating individual BRCA results was not anticipated during clinical trial design. Consequently, options were not available for patients to indicate their preference for receiving their individual results when they signed pharmacogenetic informed consent. Differences in local requirements, clinical practice, and opinion regarding the ethical aspects of how to convey genetic results to patients are all potential barriers to returning individual BRCA results to patients. Communicating the aggregate BRCA result from this study provided clinical investigators with a mechanism to disseminate the overall study finding to patients while taking individual circumstances, local guidelines and clinical practice into account. Conclusion This study illustrates the importance of increasing the clarity and scope of informed consent and the need for patient engagement to ensure clinical trial participants can indicate their preference regarding receipt of potentially important individual pharmacogenetic results. Trial registration This study was registered in the NCT Clinical Trial Registry under NCT00866697 on March 19, 2009, following approval from participating ethics committees (Additional file 1). Electronic supplementary material The online version of this article (doi:10.1186/s12910-016-0144-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- David J Pulford
- GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, UK.
| | - Philipp Harter
- AGO Study group and Department of Gynecology & Gynecologic Oncology, Kliniken Essen Mitte (KEM), Essen, Germany
| | - Anne Floquet
- GINECO and Medical Oncology, Institut Bergonié, Bordeaux, France
| | | | - Dong Hoon Suh
- Department of Obstetrics & Gynecology, KGOG and Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea
| | - Michael Friedlander
- ANZGOG and The Prince of Wales Clinical School University of New South Wales, Randwick, NSW, Australia
| | - José Angel Arranz
- GEICO and Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Kosei Hasegawa
- JGOG and Saitama Medical University International Medical Center, Hidaka, Japan
| | - Hiroomi Tada
- GlaxoSmithKline Research and Development, Philadelphia, USA.,Immuno-Oncology Development, Incyte Corporation, Wilmington, DE, USA
| | - Peter Vuylsteke
- BGOG and Medical Oncology, Université Catholique de Louvain, CHU UCL Namur, Belgium
| | | | | | - Giovanni Scambia
- Department of Woman Health, MITO and Catholic University of the Sacred Heart, Rome, Italy
| | - Toby Johnson
- GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, UK
| | - Charles Cox
- GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, UK
| | - John K Chan
- Palo Alto Medical Foundation, San Francisco, CA, USA
| | - Martin Imhof
- Karl Landsteiner Research Institute and Department of Obstetrics and Gynecology, General Public Teaching Hospital, Korneuburg, Vienna, Austria
| | - Thomas J Herzog
- NYGOG and University of Cincinnati Cancer Institute, Cincinnati, OH, USA
| | - Paula Calvert
- Cancer Trials Ireland, 60 Fitzwilliam Square N, Dublin 2, Ireland
| | - Pauline Wimberger
- AGO Germany and Department of Gynecology and Obstetrics, TU Dresden, Carl-Gustav-Carus University, Dresden, Germany
| | | | - Myong Cheol Lim
- KGOG, Gynecologic Cancer Branch and Center for Uterine Cancer, National Cancer Center, Goyang, Korea
| | | | - Chun-Fang Xu
- GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, UK
| | - Andreas du Bois
- AGO Study group and Department of Gynecology & Gynecologic Oncology, Kliniken Essen Mitte (KEM), Essen, Germany
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Channa MA, Zubair M, Haider S, Habib L, Mirza MR. Cystic Lymph Node: Caution of Safety in Calot's Triangle Dissection. Mymensingh Med J 2016; 25:772-775. [PMID: 27941745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Different landmarks are described in laparoscopic cholecystectomy for correct identification and orientation of structures to make the procedure as safe as possible. Among these one of the important landmarks is cystic lymphnode which always lies lateral to the biliary tree and forms the medial end point of dissection. This study was done to determine frequency of identification of cystic lymph node in our population. This retrospective descriptive study was conducted on 217 patients who underwent laparoscopic cholecystectomy for cholelithiasis from January 2012 to December 2013 over a period of two years in Jamal Noor Hospital and Hamdard University Hospital Karachi. All procedures were recorded and reviewed. Frequency of identification of cystic lymph node was documented in different levels of difficulty and whether it was possible to keep the dissection lateral to lymph node. Difficulty was assessed per-operatively by Cuschieri's scale. During dissection cystic lymph node was identified in 170(78.34%) cases. In majority of patients i.e. 165(97.05%), it was related to cystic artery. In 78(45.88%) patient dissection was possible lateral to lymph node. Cystic lymph node can be identified in majority of patients undergoing laparoscopic cholecystectomy and this identification helps in safe dissection of Calot's triangle. Efforts should be made to remain lateral to lymph node to avoid injuries to hepatic pedicle.
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Affiliation(s)
- M A Channa
- Dr Muhammad Ali Channa, Associate Professor, Department of Surgery, Hamdard College of Medicine & Dentistry, Hamdard University Hospital, Taj Medical Complex, Karachi, Pakistan; E-mail: drmalichanna @yahoo.com
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Harter P, Johnson T, Berton-Rigaud D, Park SY, Friedlander M, Del Campo JM, Shimada M, Forget F, Mirza MR, Colombo N, Zamagni C, Chan JK, Imhof M, Herzog TJ, O'Donnell D, Heitz F, King K, Stinnett S, Barrett C, Jobanputra M, Xu CF, du Bois A. BRCA1/2 mutations associated with progression-free survival in ovarian cancer patients in the AGO-OVAR 16 study. Gynecol Oncol 2015; 140:443-9. [PMID: 26740259 DOI: 10.1016/j.ygyno.2015.12.027] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 12/17/2015] [Accepted: 12/25/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVE AGO-OVAR 16 demonstrated that pazopanib maintenance therapy significantly increased progression-free survival (PFS) in patients with ovarian cancer whose disease had not progressed after first-line therapy. In a sub-study, we evaluated the effect of clinically important germline BRCA1 and BRCA2 mutations on PFS. METHODS Of 940 AGO-OVAR 16 participants, 664 had BRCA1/2 exon sequencing data (pazopanib, n=335; placebo, n=329). A Cox model was used to test the association between genetic variants and PFS. RESULTS Ninety-seven of 664 patients (15%) carried clinically important BRCA1/2 mutations (BRCA1/2 carriers: pazopanib 14%, placebo 16%). Median PFS was longer in BRCA1/2 mutation carriers than in BRCA1/2 non-carriers in the placebo arm (30.3 vs 14.1 months, hazard ratio, 0.48; 95% confidence interval [CI]: 0.29-0.78; P=0.0031); a similar non-significant trend was noted with pazopanib (30.2 vs 17.7 months, hazard ratio, 0.64; 95% CI: 0.40-1.03; P=0.069). Among BRCA1/2 non-carriers, PFS was longer for pazopanib-treated patients than placebo-treated patients (17.7 vs 14.1 months, hazard ratio, 0.77; 95% CI: 0.62-0.97; P=0.024). Among BRCA1/2 carriers, there was no significant PFS difference between treatments, although numbers were small (pazopanib, 46; placebo, 51), resulting in a wide CI (hazard ratio, 1.36; 95% CI: 0.66-2.82). CONCLUSIONS Patients with clinically important BRCA1/2 mutations had better prognosis. BRCA1/2 mutation status might be added as strata in future trials in primary ovarian cancer.
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Affiliation(s)
- Philipp Harter
- Department of Gynecology & Gynecologic Oncology, Kliniken Essen Mitte, Essen, Germany.
| | - Toby Johnson
- GlaxoSmithKline, Gunnels Wood Road, Stevenage SG1 2NY, UK
| | | | | | - Michael Friedlander
- The Prince of Wales Clinical School University of New South Wales, Randwick, NSW, Australia
| | - Josep M Del Campo
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Muneaki Shimada
- Department of Obstetrics and Gynecology, Tottori University School of Medicine, Nishimachi, Yonago, Japan
| | | | | | - Nicoletta Colombo
- Gynecologic Oncology, University of Milan-Bicocca and European Institute of Oncology, Milan, Italy
| | | | - John K Chan
- California Pacific and Palo Alto Sutter Cancer Research Institute, San Francisco, CA, USA
| | - Martin Imhof
- Regional Hospital Korneuburg, Medical University of Vienna, Austria
| | - Thomas J Herzog
- University of Cincinnati Cancer Institute, Cincinnati, OH, USA
| | | | - Florian Heitz
- Department of Gynecology & Gynecologic Oncology, Kliniken Essen Mitte, Essen, Germany
| | | | | | | | | | - Chun-Fang Xu
- GlaxoSmithKline, Gunnels Wood Road, Stevenage SG1 2NY, UK
| | - Andreas du Bois
- Department of Gynecology & Gynecologic Oncology, Kliniken Essen Mitte, Essen, Germany
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Colombo N, Creutzberg C, Amant F, Bosse T, González-Martín A, Ledermann J, Marth C, Nout R, Querleu D, Mirza MR, Sessa C, Altundag O, Amant F, van Leeuwenhoek A, Banerjee S, Bosse T, Casado A, de Agustín L, Cibula D, Colombo N, Creutzberg C, del Campo JM, Emons G, Goffin F, González-Martín A, Greggi S, Haie-Meder C, Katsaros D, Kesic V, Kurzeder C, Lax S, Lécuru F, Ledermann J, Levy T, Lorusso D, Mäenpää J, Marth C, Matias-Guiu X, Morice P, Nijman H, Nout R, Powell M, Querleu D, Mirza M, Reed N, Rodolakis A, Salvesen H, Sehouli J, Sessa C, Taylor A, Westermann A, Zeimet A. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up. Ann Oncol 2015; 27:16-41. [PMID: 26634381 DOI: 10.1093/annonc/mdv484] [Citation(s) in RCA: 685] [Impact Index Per Article: 76.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/05/2015] [Indexed: 12/27/2022] Open
Abstract
The first joint European Society for Medical Oncology (ESMO), European SocieTy for Radiotherapy & Oncology (ESTRO) and European Society of Gynaecological Oncology (ESGO) consensus conference on endometrial cancer was held on 11-13 December 2014 in Milan, Italy, and comprised a multidisciplinary panel of 40 leading experts in the management of endometrial cancer. Before the conference, the expert panel prepared three clinically relevant questions about endometrial cancer relating to the following four areas: prevention and screening, surgery, adjuvant treatment and advanced and recurrent disease. All relevant scientific literature, as identified by the experts, was reviewed in advance. During the consensus conference, the panel developed recommendations for each specific question and a consensus was reached. Results of this consensus conference, together with a summary of evidence supporting each recommendation, are detailed in this article. All participants have approved this final article.
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Affiliation(s)
- N Colombo
- Division of Medical Gynecologic Oncology, European Institute of Oncology and University of Milan-Bicocca, Milan, Italy
| | - C Creutzberg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - F Amant
- Department of Gynecological Oncology, University Hospital Leuven, Leuven, Belgium Center for Gynecological Oncology Amsterdam (CGOA), Antoni van Leeuwenhoek, Amsterdam
| | - T Bosse
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - A González-Martín
- Department of Medical Oncology, GEICO Cancer Center, Madrid Department of Medical Oncology, MD Anderson Cancer Center, Madrid, Spain
| | - J Ledermann
- Department of Oncology and Cancer Trials, UCL Cancer Institute, London, UK
| | - C Marth
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria
| | - R Nout
- Department of Radiotherapy, Leiden University Medical Center, Leiden, The Netherlands
| | - D Querleu
- Department of Surgery, Institut Bergonié, Bordeaux, France Department of Gynecology and Obstetrics, McGill University Health Centre, Montreal, Canada
| | - M R Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - C Sessa
- Department of Medical Oncology, Oncology Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland
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du Bois A, Kristensen G, Ray-Coquard I, Reuss A, Pignata S, Colombo N, Denison U, Vergote I, Del Campo JM, Ottevanger P, Heubner M, Minarik T, Sevin E, de Gregorio N, Bidziński M, Pfisterer J, Malander S, Hilpert F, Mirza MR, Scambia G, Meier W, Nicoletto MO, Bjørge L, Lortholary A, Sailer MO, Merger M, Harter P. Standard first-line chemotherapy with or without nintedanib for advanced ovarian cancer (AGO-OVAR 12): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet Oncol 2015; 17:78-89. [PMID: 26590673 DOI: 10.1016/s1470-2045(15)00366-6] [Citation(s) in RCA: 164] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 09/22/2015] [Accepted: 09/23/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Angiogenesis is a target in the treatment of ovarian cancer. Nintedanib, an oral triple angiokinase inhibitor of VEGF receptor, platelet-derived growth factor receptor, and fibroblast growth factor receptor, has shown activity in phase 2 trials in this setting. We investigated the combination of nintedanib with standard carboplatin and paclitaxel chemotherapy in patients with newly diagnosed advanced ovarian cancer. METHODS In this double-blind phase 3 trial, chemotherapy-naive patients (aged 18 years or older) with International Federation of Gynecology and Obstetrics (FIGO) IIB-IV ovarian cancer and upfront debulking surgery were stratified by postoperative resection status, FIGO stage, and planned carboplatin dose. Patients were randomly assigned (2:1) via an interactive voice or web-based response system to receive six cycles of carboplatin (AUC 5 mg/mL per min or 6 mg/mL per min) and paclitaxel (175 mg/m(2)) in addition to either 200 mg of nintedanib (nintedanib group) or placebo (placebo group) twice daily on days 2-21 of every 3-week cycle for up to 120 weeks. Patients, investigators, and independent radiological reviewers were masked to treatment allocation. The primary endpoint was investigator-assessed progression-free survival analysed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT01015118. FINDINGS Between Dec 9, 2009, and July 27, 2011, 1503 patients were screened and 1366 randomly assigned by nine study groups in 22 countries: 911 to the nintedanib group and 455 to the placebo group. 486 (53%) of 911 patients in the nintedanib group experienced disease progression or death compared with 266 (58%) of 455 in the placebo group. Median progression-free survival was significantly longer in the nintedanib group than in the placebo group (17·2 months [95% CI 16·6-19·9] vs 16·6 months [13·9-19·1]; hazard ratio 0·84 [95% CI 0·72-0·98]; p=0·024). The most common adverse events were gastrointestinal (diarrhoea: nintedanib group 191 [21%] of 902 grade 3 and three [<1%] grade 4 vs placebo group nine [2%] of 450 grade 3 only) and haematological (neutropenia: nintedanib group 180 [20%] grade 3 and 200 (22%) grade 4 vs placebo group 90 [20%] grade 3 and 72 [16%] grade 4; thrombocytopenia: 105 [12%] and 55 [6%] vs 21 [5%] and eight [2%]; anaemia: 108 [12%] and 13 [1%] vs 26 [6%] and five [1%]). Serious adverse events were reported in 376 (42%) of 902 patients in the nintedanib group and 155 (34%) of 450 in the placebo group. 29 (3%) of 902 patients in the nintedanib group experienced serious adverse events associated with death compared with 16 (4%) of 450 in the placebo group, including 12 (1%) in the nintedanib group and six (1%) in the placebo group with a malignant neoplasm progression classified as an adverse event by the investigator. Drug-related adverse events leading to death occurred in three patients in the nintedanib group (one without diagnosis of cause; one due to non-drug-related sepsis associated with drug-related diarrhoea and renal failure; and one due to peritonitis) and in one patient in the placebo group (cause unknown). INTERPRETATION Nintedanib in combination with carboplatin and paclitaxel is an active first-line treatment that significantly increases progression-free survival for women with advanced ovarian cancer, but is associated with more gastrointestinal adverse events. Future studies should focus on improving patient selection and optimisation of tolerability. FUNDING Boehringer Ingelheim.
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Affiliation(s)
| | - Gunnar Kristensen
- Department of Gynecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, and Oslo University, Oslo, Norway
| | | | | | | | - Nicoletta Colombo
- University of Milan Bicocca, Milan, Italy; European Institute of Oncology Milan, Milan, Italy
| | - Ursula Denison
- Health + Life Gesundheitsmanagement GmbH, Vienna, Austria
| | | | | | | | - Martin Heubner
- West German Tumor Center, Department of Gynecology and Obstetrics, University of Duisburg-Essen, Essen, Germany
| | | | - Emmanuel Sevin
- Centre François Baclesse, Comité Uro-Gynécologie, Caen, France
| | | | - Mariusz Bidziński
- Faculty of Health Science, University of Jan Kochanowski, Kielce, Poland
| | | | | | - Felix Hilpert
- Universitäts-Klinik Schleswig-Holstein (UKSH) Campus Kiel, Department of Gynecology and Obstetrics, Kiel, Germany
| | - Mansoor R Mirza
- Rigshospitalet-Copenhagen University Hospital, Department of Oncology, Copenhagen, Denmark
| | - Giovanni Scambia
- Universita Cattolica del Sacro Cuore Policlinico Gemelli, Rome, Italy
| | - Werner Meier
- Evangelisches Krankenhaus, Department of Gynecology and Obstetrics, Duesseldorf, Germany
| | - Maria O Nicoletto
- Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCSS), Oncologia MedicaI, Padova, Italy
| | - Line Bjørge
- Haukeland Universitetssykehus, Bergen, Norway
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Oza AM, Cook AD, Pfisterer J, Embleton A, Ledermann JA, Pujade-Lauraine E, Kristensen G, Carey MS, Beale P, Cervantes A, Park-Simon TW, Rustin G, Joly F, Mirza MR, Plante M, Quinn M, Poveda A, Jayson GC, Stark D, Swart AM, Farrelly L, Kaplan R, Parmar MKB, Perren TJ. Standard chemotherapy with or without bevacizumab for women with newly diagnosed ovarian cancer (ICON7): overall survival results of a phase 3 randomised trial. Lancet Oncol 2015; 16:928-36. [PMID: 26115797 PMCID: PMC4648090 DOI: 10.1016/s1470-2045(15)00086-8] [Citation(s) in RCA: 552] [Impact Index Per Article: 61.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 04/29/2015] [Accepted: 05/01/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND The ICON7 trial previously reported improved progression-free survival in women with ovarian cancer with the addition of bevacizumab to standard chemotherapy, with the greatest effect in patients at high risk of disease progression. We report the final overall survival results of the trial. METHODS ICON7 was an international, phase 3, open-label, randomised trial undertaken at 263 centres in 11 countries across Europe, Canada, Australia and New Zealand. Eligible adult women with newly diagnosed ovarian cancer that was either high-risk early-stage disease (International Federation of Gynecology and Obstetrics [FIGO] stage I-IIa, grade 3 or clear cell histology) or more advanced disease (FIGO stage IIb-IV), with an Eastern Cooperative Oncology Group performance status of 0-2, were enrolled and randomly assigned in a 1:1 ratio to standard chemotherapy (six 3-weekly cycles of intravenous carboplatin [AUC 5 or 6] and paclitaxel 175 mg/m(2) of body surface area) or the same chemotherapy regimen plus bevacizumab 7·5 mg per kg bodyweight intravenously every 3 weeks, given concurrently and continued with up to 12 further 3-weekly cycles of maintenance therapy. Randomisation was done by a minimisation algorithm stratified by FIGO stage, residual disease, interval between surgery and chemotherapy, and Gynecologic Cancer InterGroup group. The primary endpoint was progression-free survival; the study was also powered to detect a difference in overall survival. Analysis was by intention to treat. This trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN91273375. FINDINGS Between Dec 18, 2006, and Feb 16, 2009, 1528 women were enrolled and randomly assigned to receive chemotherapy (n=764) or chemotherapy plus bevacizumab (n=764). Median follow-up at the end of the trial on March 31, 2013, was 48·9 months (IQR 26·6-56·2), at which point 714 patients had died (352 in the chemotherapy group and 362 in the bevacizumab group). Our results showed evidence of non-proportional hazards, so we used the difference in restricted mean survival time as the primary estimate of effect. No overall survival benefit of bevacizumab was recorded (restricted mean survival time 44·6 months [95% CI 43·2-45·9] in the standard chemotherapy group vs 45·5 months [44·2-46·7] in the bevacizumab group; log-rank p=0·85). In an exploratory analysis of a predefined subgroup of 502 patients with poor prognosis disease, 332 (66%) died (174 in the standard chemotherapy group and 158 in the bevacizumab group), and a significant difference in overall survival was noted between women who received bevacizumab plus chemotherapy and those who received chemotherapy alone (restricted mean survival time 34·5 months [95% CI 32·0-37·0] with standard chemotherapy vs 39·3 months [37·0-41·7] with bevacizumab; log-rank p=0·03). However, in non-high-risk patients, the restricted mean survival time did not differ significantly between the two treatment groups (49·7 months [95% CI 48·3-51·1]) in the standard chemotherapy group vs 48·4 months [47·0-49·9] in the bevacizumab group; p=0·20). An updated analysis of progression-free survival showed no difference between treatment groups. During extended follow-up, one further treatment-related grade 3 event (gastrointestinal fistula in a bevacizumab-treated patient), three grade 2 treatment-related events (cardiac failure, sarcoidosis, and foot fracture, all in bevacizumab-treated patients), and one grade 1 treatment-related event (vaginal haemorrhage, in a patient treated with standard chemotherapy) were reported. INTERPRETATION Bevacizumab, added to platinum-based chemotherapy, did not increase overall survival in the study population as a whole. However, an overall survival benefit was recorded in poor-prognosis patients, which is concordant with the progression-free survival results from ICON7 and GOG-218, and provides further evidence towards the optimum use of bevacizumab in the treatment of ovarian cancer. FUNDING The National Institute for Health Research through the UK National Cancer Research Network, the Medical Research Council, and Roche.
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Affiliation(s)
- Amit M Oza
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Adrian D Cook
- Medical Research Council Clinical Trials Unit at University College London, London, UK.
| | | | - Andrew Embleton
- Medical Research Council Clinical Trials Unit at University College London, London, UK
| | | | | | - Gunnar Kristensen
- Department of Gynaecologic Oncology and Institute for Cancer Genetics and Informatics, Oslo University Hospital, Institute for Clinical Medicine, Oslo University, Norway
| | - Mark S Carey
- University of British Columbia, Vancouver, Canada
| | | | - Andrés Cervantes
- Department of Haematology and Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | | | | | | | - Mansoor R Mirza
- Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Marie Plante
- Centre Hospitalier Universitaire de Québec, L'Hôtel-Dieu de Québec, Canada
| | | | - Andrés Poveda
- Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Gordon C Jayson
- Institute of Cancer Sciences and Christie Hospital, University of Manchester, Manchester, UK
| | - Dan Stark
- St James Institute of Oncology, St James University Hospital, Leeds, UK
| | - Ann Marie Swart
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Laura Farrelly
- Medical Research Council Clinical Trials Unit at University College London, London, UK
| | - Richard Kaplan
- Medical Research Council Clinical Trials Unit at University College London, London, UK
| | - Mahesh K B Parmar
- Medical Research Council Clinical Trials Unit at University College London, London, UK
| | - Timothy J Perren
- St James Institute of Oncology, St James University Hospital, Leeds, UK
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45
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du Bois A, Floquet A, Kim JW, Rau J, del Campo JM, Friedlander M, Pignata S, Fujiwara K, Vergote I, Colombo N, Mirza MR, Monk BJ, Kimmig R, Ray-Coquard I, Zang R, Diaz-Padilla I, Baumann KH, Mouret-Reynier MA, Kim JH, Kurzeder C, Lesoin A, Vasey P, Marth C, Canzler U, Scambia G, Shimada M, Calvert P, Pujade-Lauraine E, Kim BG, Herzog TJ, Mitrica I, Schade-Brittinger C, Wang Q, Crescenzo R, Harter P. Incorporation of Pazopanib in Maintenance Therapy of Ovarian Cancer. J Clin Oncol 2014; 32:3374-82. [DOI: 10.1200/jco.2014.55.7348] [Citation(s) in RCA: 265] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PurposePazopanib is an oral, multikinase inhibitor of vascular endothelial growth factor receptor (VEGFR) -1/-2/-3, platelet-derived growth factor receptor (PDGFR) -α/-β, and c-Kit. Preclinical and clinical studies support VEGFR and PDGFR as targets for advanced ovarian cancer treatment. This study evaluated the role of pazopanib maintenance therapy in patients with ovarian cancer whose disease did not progress during first-line chemotherapy.Patients and MethodsNine hundred forty patients with histologically confirmed cancer of the ovary, fallopian tube, or peritoneum, International Federation Gynecology Obstetrics (FIGO) stages II-IV, no evidence of progression after primary therapy consisting of surgery and at least five cycles of platinum-taxane chemotherapy were randomized 1:1 to receive pazopanib 800 mg once per day or placebo for up to 24 months. The primary end point was progression-free survival by RECIST 1.0 assessed by the investigators.ResultsMaintenance pazopanib prolonged progression-free survival compared with placebo (hazard ratio [HR], 0.77; 95% CI, 0.64 to 0.91; P = .0021; median, 17.9 v 12.3 months, respectively). Interim survival analysis based on events in 35.6% of the population did not show any significant difference. Grade 3 or 4 adverse events of hypertension (30.8%), neutropenia (9.9%), liver-related toxicity (9.4%), diarrhea (8.2%), fatigue (2.7%), thrombocytopenia (2.5%), and palmar-plantar erythrodysesthesia (1.9%) were significantly higher in the pazopanib arm. Treatment discontinuation related to adverse events was higher among patients treated with pazopanib (33.3%) compared with placebo (5.6%).ConclusionPazopanib maintenance therapy provided a median improvement of 5.6 months (HR, 0.77) in progression-free survival in patients with advanced ovarian cancer who have not progressed after first-line chemotherapy. Overall survival data to this point did not suggest any benefit. Additional analysis should help to identify subgroups of patients in whom improved efficacy may balance toxicity (NCT00866697).
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Affiliation(s)
- Andreas du Bois
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Anne Floquet
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Jae-Weon Kim
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Joern Rau
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Josep M. del Campo
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Michael Friedlander
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Sandro Pignata
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Keiichi Fujiwara
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Ignace Vergote
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Nicoletta Colombo
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Mansoor R. Mirza
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Bradley J. Monk
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Rainer Kimmig
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Isabelle Ray-Coquard
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Rongyu Zang
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Ivan Diaz-Padilla
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Klaus H. Baumann
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Marie-Ange Mouret-Reynier
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Jae-Hoon Kim
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Christian Kurzeder
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Anne Lesoin
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Paul Vasey
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Christian Marth
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Ulrich Canzler
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Giovanni Scambia
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Muneaki Shimada
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Paula Calvert
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Eric Pujade-Lauraine
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Byoung-Gie Kim
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Thomas J. Herzog
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Ionel Mitrica
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Carmen Schade-Brittinger
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Qiong Wang
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Rocco Crescenzo
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
| | - Philipp Harter
- Andreas du Bois, Rainer Kimmig, Klaus H. Baumann, Christian Kurzeder, Ulrich Canzler, Philipp Harter, AGO Ovarian Cancer Study Group (AGO); Andreas du Bois, Christian Kurzeder, Philipp Harter, Kliniken Essen Mitte; Rainer Kimmig, West German Tumor Center, University of Duisburg-Essen, Essen; Joern Rau, Carmen Schade-Brittinger, Coordinating Center for Clinical Trials, Philipps-University of Marburg; Klaus H. Baumann, University of Marburg, Marburg; Ulrich Canzler, University Hospitals Carl Gustav Carus,
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Lindemann K, Malander S, Christensen RD, Mirza MR, Kristensen GB, Aavall-Lundqvist E, Vergote I, Rosenberg P, Boman K, Nordstrøm B. Examestane in advanced or recurrent endometrial carcinoma: a prospective phase II study by the Nordic Society of Gynecologic Oncology (NSGO). BMC Cancer 2014; 14:68. [PMID: 24498853 PMCID: PMC3924910 DOI: 10.1186/1471-2407-14-68] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 01/30/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We evaluated the efficacy and safety of the aromatase inhibitor exemestane in patients with advanced, persistent or recurrent endometrial carcinoma. METHODS We performed an open-label one-arm, two-stage, phase II study of 25 mg of oral exemestane in 51 patients with advanced (FIGO stage III-IV) or relapsed endometrioid endometrial cancer. Patients were stratified into subsets of estrogen receptor (ER) positive and ER negative patients. RESULTS Recruitment to the ER negative group was stopped prematurely after 12 patients due to slow accrual. In the ER positive patients, we observed an overall response rate of 10%, and a lack of progression after 6 months in 35% of the patients. No responses were registered in the ER negative patients, and all had progressive disease within 6 months. For the total group of patients, the median progression free survival (PFS) was 3.1 months (95% CI: 2.0-4.1). In the ER positive patients the median PFS was 3.8 months (95% CI: 0.7-6.9) and in the ER negative patients it was 2.6 months (95% CI: 2.1-3-1). In the ER positive patients the median overall survival (OS) time was 13.3 months (95% CI: 7.7-18.9), in the ER negative patients the corresponding numbers were 6.1 months (95% CI: 4.1-8.2). Treatment with exemestane was well tolerated. CONCLUSION Treatment of estrogen positive advanced or recurrent endometrial cancer with exemestane, an aromatase inhibitor, resulted in a response rate of 10% and lack of progression after 6 months in 35% of the patients. TRIAL REGISTRATION Trial identification number (Clinical Trials.gov): NCT01965080.Nordic Society of Gynecological Oncology: NSGO-EC-0302.EudraCT number: 2004-001103-35.
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Affiliation(s)
- Kristina Lindemann
- Department of Gynecologic Oncology, Norwegian Radium Hospital, Oslo University Hospital, Nydalen 0424, PB 4953, Oslo, Norway
| | - Susanne Malander
- Department of gynecologic oncology, Lund University Hospital, Lund, Sweden
| | - Rene D Christensen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Mansoor R Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Gunnar B Kristensen
- Department of Gynecologic Oncology, Norwegian Radium Hospital, Oslo University Hospital, Nydalen 0424, PB 4953, Oslo, Norway
- Department of Gynecologic Oncology and Institute for Medical Informatics, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | | | - Ignace Vergote
- Department of Gynecologic Oncology and Leuven Cancer Institute, University Hospital Leuven, Leuven, European Union
| | - Per Rosenberg
- Department of Gynecologic Oncology, University Hospital, Linkjoeping, Sweden
| | - Karin Boman
- Department of Oncology, University Hospital, Umeaa, Sweden
| | - Britta Nordstrøm
- Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
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Habib L, Mirza MR, Zubair M. Hernioplasty for ventral hernias: correlation of wound morbidity with body mass index. Mymensingh Med J 2013; 22:820-824. [PMID: 24292317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
To determine the correlation of wound morbidity especially serum drain output in on lay mesh hernioplasty with Body Mass Index (BMI). This prospective descriptive study was conducted at Hamdard University Hospital and Jamal Noor Hospital from January 2010 to December 2011. A total of 42 females with ventral hernias were included. According to BMI, patients were divided in two groups. Group 1(G-1) included patients with BMI ≤29.9 and Group 2(G-2) included patients with BMI ≥30. All patients underwent hernioplasty by conventional open method (on lay technique). Wound was closed over a vaccum drain (16 Fr). Total drain output, the number of days drain kept, clinical seroma formation & need of aspiration after removal of drain, discharge from the wound and wound infection were recorded and analyzed on SPSS version 15 by using sample 't' test. A total of 42 female patients, 21 in each group, were included with the mean age of 46.95 years. Size of hernial defect was 4.80cm in G-1 and 4.61cm in G-2. Mean drain out- put in G-1 was 134.05ml while in G-2 it was 244.29ml (p=0.008). Duration of drainage in G-1 was 3.71 days and in G-2 was 5.24 days (p=0.028). Seroma formation and serous discharge from the wound occurred in 2(4.76%) patients, both were from Group-1 and they required aspiration once only. Wound infection occurred in 4(9.52%) patients, and all were in Group 2. Post operative drain output in on lay mesh hernioplasty is directly proportional to the Body Mass Index (BMI) and these are the patients who require a longer period of drainage therefore this fact should be explained to obese patients in pre operative informed consent.
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Affiliation(s)
- L Habib
- Dr Lubna Habib, Associate Professor, Department of Surgery, Hamdard College of Medicine & Dentistry, Hamdard University Hospital, Karachi, Pakistan
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Perren TJ, Swart AM, Pfisterer J, Ledermann JA, Pujade-Lauraine E, Kristensen G, Carey MS, Beale P, Cervantes A, Kurzeder C, du Bois A, Sehouli J, Kimmig R, Stähle A, Collinson F, Essapen S, Gourley C, Lortholary A, Selle F, Mirza MR, Leminen A, Plante M, Stark D, Qian W, Parmar MKB, Oza AM. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med 2011; 365:2484-96. [PMID: 22204725 DOI: 10.1056/nejmoa1103799] [Citation(s) in RCA: 1493] [Impact Index Per Article: 114.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Angiogenesis plays a role in the biology of ovarian cancer. We examined the effect of bevacizumab, the vascular endothelial growth factor inhibitor, on survival in women with this disease. METHODS We randomly assigned women with ovarian cancer to carboplatin (area under the curve, 5 or 6) and paclitaxel (175 mg per square meter of body-surface area), given every 3 weeks for 6 cycles, or to this regimen plus bevacizumab (7.5 mg per kilogram of body weight), given concurrently every 3 weeks for 5 or 6 cycles and continued for 12 additional cycles or until progression of disease. Outcome measures included progression-free survival, first analyzed per protocol and then updated, and interim overall survival. RESULTS A total of 1528 women from 11 countries were randomly assigned to one of the two treatment regimens. Their median age was 57 years; 90% had epithelial ovarian cancer, 69% had a serous histologic type, 9% had high-risk early-stage disease, 30% were at high risk for progression, and 70% had stage IIIC or IV ovarian cancer. Progression-free survival (restricted mean) at 36 months was 20.3 months with standard therapy, as compared with 21.8 months with standard therapy plus bevacizumab (hazard ratio for progression or death with bevacizumab added, 0.81; 95% confidence interval, 0.70 to 0.94; P=0.004 by the log-rank test). Nonproportional hazards were detected (i.e., the treatment effect was not consistent over time on the hazard function scale) (P<0.001), with a maximum effect at 12 months, coinciding with the end of planned bevacizumab treatment and diminishing by 24 months. Bevacizumab was associated with more toxic effects (most often hypertension of grade 2 or higher) (18%, vs. 2% with chemotherapy alone). In the updated analyses, progression-free survival (restricted mean) at 42 months was 22.4 months without bevacizumab versus 24.1 months with bevacizumab (P=0.04 by log-rank test); in patients at high risk for progression, the benefit was greater with bevacizumab than without it, with progression-free survival (restricted mean) at 42 months of 14.5 months with standard therapy alone and 18.1 months with bevacizumab added, with respective median overall survival of 28.8 and 36.6 months. CONCLUSIONS Bevacizumab improved progression-free survival in women with ovarian cancer. The benefits with respect to both progression-free and overall survival were greater among those at high risk for disease progression. (Funded by Roche and others; ICON7 Controlled-Trials.com number, ISRCTN91273375.).
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Affiliation(s)
- Timothy J Perren
- St. James's Institute of Oncology, St. James's University Hospital, Leeds, United Kingdom
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Bergmann TK, Brasch-Andersen C, Gréen H, Mirza MR, Skougaard K, Wihl J, Keldsen N, Damkier P, Peterson C, Vach W, Brøsen K. Impact of ABCB1 Variants on Neutrophil Depression: A Pharmacogenomic Study of Paclitaxel in 92 Women with Ovarian Cancer. Basic Clin Pharmacol Toxicol 2011; 110:199-204. [DOI: 10.1111/j.1742-7843.2011.00802.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lajer H, Jensen MB, Kilsmark J, Albæk J, Svane D, Mirza MR, Geertsen PF, Reerman D, Hansen K, Milter MC, Mogensen O. The value of gynecologic cancer follow-up: evidence-based ignorance? Int J Gynecol Cancer 2011; 20:1307-20. [PMID: 21051970 DOI: 10.1111/igc.0b013e3181f3bee0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION To explore the extent of evidence-based data and cost-utility of follow-up after primary treatment of endometrial and ovarian cancer, addressing perspectives of technology, organization, economics, and patients. METHODS Systematic literature searches according to the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions were conducted separately for each of the 4 perspectives. In addition, the organizational analysis included a nationwide questionnaire survey among all relevant hospital departments, and the operating costs were calculated. RESULTS None of the identified studies supported a survival benefit from hospital-based follow-up after completion of primary treatment of endometrial or ovarian cancer. The methods for follow-up were of low technology (gynecologic examination with or without ultrasound examination). Other technologies had poor sensitivity and specificity in detecting recurrence. Small changes in applied technologies and organization lead to substantial changes in costs. Substantial differences especially in frequency and applied methods were found between departments. The literature review did not find evidence that follow-up affects the women's quality of life. CONCLUSIONS The main purpose of follow-up after treatment of cancer is improved survival. Our review of the literature showed no evidence of a positive effect on survival in women followed up after primary treatment of endometrial or ovarian cancer. The conception of follow-up among physicians, patients, and their relatives therefore needs revision. Follow-up after treatment should have a clearly defined and evidence-based purpose. Based on the existing literature, this purpose should presently focus on other end points rather than early detection of relapse and improved survival. These end points could be quality of life, treatment toxicity, and economy.
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Affiliation(s)
- Henrik Lajer
- Department of Gynecology and Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
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