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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; 35:414-428. [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] [MESH Headings] [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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McNeish IA, Monk BJ. Is more of a good thing still a good thing? PARP inhibitor retreatment in high-grade ovarian carcinoma. Ann Oncol 2023; 34:1074-1076. [PMID: 38072509 DOI: 10.1016/j.annonc.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 12/18/2023] Open
Affiliation(s)
- I A McNeish
- Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK.
| | - B J Monk
- HonorHealth Research Institute, Division of Gynecologic Oncology, University of Arizona College of Medicine, Phoenix, USA
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Pothuri B, Blank SV, Myers TK, Hines JF, Randall LM, O'Cearbhaill RE, Slomovitz BM, Eskander RN, Alvarez Secord A, Coleman RL, Walker JL, Monk BJ, Moore KN, O'Malley DM, Copeland LJ, Herzog TJ. Inclusion, diversity, equity, and access (IDEA) in gynecologic cancer clinical trials: A joint statement from GOG foundation and Society of Gynecologic Oncology (SGO). Gynecol Oncol 2023; 174:278-287. [PMID: 37315373 DOI: 10.1016/j.ygyno.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 06/16/2023]
Affiliation(s)
- B Pothuri
- NYU Langone Health and Laura & Isaac Perlmutter Cancer Center, New York, NY, USA.
| | - S V Blank
- Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, Blavatnik Family Women's Health Research Institute, New York, MY, USA
| | - T K Myers
- University of Massachusetts-Baystate, Springfield, MA, USA
| | - J F Hines
- University of Connecticut Health System, Farmington, CT, USA
| | - L M Randall
- Virginia Commonwealth University, Richmond, VA, USA
| | - R E O'Cearbhaill
- Memorial Sloan Kettering Cancer Center; Weill Cornell Medical College, New York, NY, USA
| | | | - R N Eskander
- University of California, San Diego Moores Cancer Center, La Jolla, CA, USA
| | - A Alvarez Secord
- Duke Cancer Institute, Duke University Health System, Durham, NC, USA
| | - R L Coleman
- Texas Oncology, US Oncology Network, The Woodlands, TX, USA
| | - J L Walker
- Stephenson Cancer Center, Oklahoma City, OK, USA
| | - B J Monk
- University of Arizona College of Medicine, Phoenix, AZ, USA
| | - K N Moore
- Stephenson Cancer Center, Oklahoma City, OK, USA
| | - D M O'Malley
- The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center Columbus, OH, USA
| | - L J Copeland
- The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center Columbus, OH, USA
| | - T J Herzog
- University of Cincinnati Cancer Center, University of Cincinnati, Cincinnati, OH, USA
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Van der Kolk WL, Van der Zee AGJ, Slomovitz BM, Baldwin PJW, Van Doorn HC, De Hullu JA, Van der Velden J, Gaarenstroom KN, Slangen BFM, Kjolhede P, Brännström M, Vergote I, Holland CM, Coleman R, Van Dorst EBL, Van Driel WJ, Nunns D, Widschwendter M, Nugent D, DiSilvestro PA, Mannel RS, Tjiong MY, Boll D, Cibula D, Covens A, Provencher D, Runnebaum IB, Monk BJ, Zanagnolo V, Tamussino K, Oonk MHM. Unilateral inguinofemoral lymphadenectomy in patients with early-stage vulvar squamous cell carcinoma and a unilateral metastatic sentinel lymph node is safe. Gynecol Oncol 2022; 167:3-10. [PMID: 36085090 DOI: 10.1016/j.ygyno.2022.07.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 06/23/2022] [Accepted: 07/18/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Optimal management of the contralateral groin in patients with early-stage vulvar squamous cell carcinoma (VSCC) and a metastatic unilateral inguinal sentinel lymph node (SN) is unclear. We analyzed patients who participated in GROINSS-V I or II to determine whether treatment of the contralateral groin can safely be omitted in patients with a unilateral metastatic SN. METHODS We selected the patients with a unilateral metastatic SN from the GROINSS-V I and II databases. We determined the incidence of contralateral additional non-SN metastases in patients with unilateral SN-metastasis who underwent bilateral inguinofemoral lymphadenectomy (IFL). In those who underwent only ipsilateral groin treatment or no further treatment, we determined the incidence of contralateral groin recurrences during follow-up. RESULTS Of 1912 patients with early-stage VSCC, 366 had a unilateral metastatic SN. Subsequently, 244 had an IFL or no treatment of the contralateral groin. In seven patients (7/244; 2.9% [95% CI: 1.4%-5.8%]) disease was diagnosed in the contralateral groin: five had contralateral non-SN metastasis at IFL and two developed an isolated contralateral groin recurrence after no further treatment. Five of them had a primary tumor ≥30 mm. Bilateral radiotherapy was administered in 122 patients, of whom one (1/122; 0.8% [95% CI: 0.1%-4.5%]) had a contralateral groin recurrence. CONCLUSION The risk of contralateral lymph node metastases in patients with early-stage VSCC and a unilateral metastatic SN is low. It appears safe to limit groin treatment to unilateral IFL or inguinofemoral radiotherapy in these cases.
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Affiliation(s)
- W L Van der Kolk
- University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - A G J Van der Zee
- University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - B M Slomovitz
- Mount Sinai Medical Center, Miami Beach, FL, United States of America
| | - P J W Baldwin
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - H C Van Doorn
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - J A De Hullu
- Radboud University Medical Center, Nijmegen, the Netherlands
| | | | | | - B F M Slangen
- Maastricht University Medical Center+, Maastricht, the Netherlands
| | | | - M Brännström
- Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - I Vergote
- Leuven Cancer Institute, Leuven, Belgium
| | - C M Holland
- Manchester University NHS Foundation Trust-St Marys Hospital, Manchester, United Kingdom
| | - R Coleman
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | | | - W J Van Driel
- Center of Gynecological Oncology Amsterdam, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - D Nunns
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - M Widschwendter
- European Translational Oncology Prevention and Screening (EUTOPS) Institute, University Innsbruck, Austria
| | - D Nugent
- Leeds Teaching Hospitals NHS Trust, St James' University Hospital, Leeds, United Kingdom
| | - P A DiSilvestro
- Women and Infants Hospital of Rhode Island, Providence, RI, United States of America
| | - R S Mannel
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, United States of America
| | - M Y Tjiong
- Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - D Boll
- Catharina Ziekenhuis Eindhoven, the Netherlands
| | - D Cibula
- First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - A Covens
- University of Toronto, Toronto, Ontario, Canada
| | - D Provencher
- CHUM, Université de Montréal, Montréal, Quebec, Canada
| | - I B Runnebaum
- Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - B J Monk
- St Josephs Hospital and Medical Center, Phoenix, AZ, United States of America
| | - V Zanagnolo
- Department of Obstetrics and Gynaecology, European Cancer Institute, Milan, Italy
| | | | - M H M Oonk
- University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
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Heitz F, Valabrega G, Pothuri B, Oaknin A, Graybill W, Sánchez AB, McCormick C, Baurain JF, Hoskins P, Denys H, O’Cearbhaill RE, Hietanen S, Moore RG, Knudsen AØ, de La Motte Rouge T, Levy T, Li Y, Gupta D, Monk BJ, González-Martín A. Efficacy and safety of niraparib in older patients with advanced ovarian cancer (OC): results from the PRIMA/ENGOT-OV26/GOG-3012 trial. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718222] [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: 10/23/2022] Open
Affiliation(s)
- F Heitz
- Kliniken Essen-Mitte, Department for Gynecology and Gynecologic Oncology
| | - G Valabrega
- FPO-IRCCS Candiolo, Candiolo Cancer Institute
- University of Torino, Department of Oncology
| | - B Pothuri
- Gynecologic Oncology Group (GOG) and Perlmutter Cancer Center, NYU Langone Health, Department of Obstetrics/Gynecology
| | - A Oaknin
- Vall d´Hebron University Hospital and Vall d´Hebron Institute of Oncology (VHIO)
| | | | - AB Sánchez
- Hospital General Universitario de Elche, Unit of Genetic Counseling in Cancer, Medical Oncology Department
| | | | - JF Baurain
- Université Catholique de Louvain and Cliniques Universitaires Saint-Luc
| | - P Hoskins
- British Columbia Cancer Agency, Vancouver Centre, Medical Oncology
| | | | - RE O’Cearbhaill
- Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, Department of Medicine
| | - S Hietanen
- Turku University Hospital, Department of Obstetrics and Gynecology
| | - RG Moore
- University of Rochester, Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology
| | | | | | - T Levy
- Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Department of Obstetrics and Gynecology
| | | | | | - BJ Monk
- Arizona Oncology (US Oncology Network), University of Arizona College of Medicine
| | - A González-Martín
- Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Clínica Universidad de Navarra, Medical Oncology Department
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Marmé F, MR M, González-Martin A, Graybill W, O’Malley DM, Gaba L, OWS Y, Guerra E, Rose P, JF B, Ghamande S, Denys H, Prendergast E, Pisano C, Follana P, Baumann K, PM C, Korach J, Li Y, Gupta D, BJ M. Evaluation of an individualized starting dose of niraparib in the PRIMA/ENGOT-OV26/GOG-3012 study. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718220] [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: 10/23/2022] Open
Affiliation(s)
- F Marmé
- Universitätsklinikum Heidelberg, Faculty of Medicine
| | - Mirza MR
- Nordic Society of Gynaecological Oncology (NSGO)
- Rigshospitalet
| | | | - W Graybill
- Medical University of South Carolina, GOG, Gynecologic Oncology
| | | | - L Gaba
- Hospital Clinic de Barcelona, Medical Oncology Department
| | - Yap OWS
- University Gynecologic Oncology
| | - E Guerra
- Hospital Universitario Ramón y Cajal
| | | | - Baurain JF
- Cliniques Universitaires Saint-Luc, Université catholique de Louvain
| | - S Ghamande
- Georgia Cancer Center, Augusta University
| | | | | | - C Pisano
- Istituto Nazionale Tumori IRCCS Fondazione Pascale
| | | | - K Baumann
- Klinikum der Stadt Ludwigshafen, Department of Gynecology and Obstetrics
| | | | - J Korach
- Sackler Medical School Tel Aviv University, The Chaim Sheba Medical Center, Department of Oncology
| | | | | | - Monk BJ
- Arizona Oncology (US Oncology Network), University of Arizona College of Medicine
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7
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Heitz F, Pothuri B, Han S, Chase D, Burger R, Gaba L, Van Le L, Guerra E, Bender D, Korach J, Cloven N, Follana P, Baurain JF, Pisano C, Peen U, Maenpaa J, Bacque E, Li Y, González-Martin A, Monk BJ. Patient-reported outcomes (PRO) in patients receiving niraparib in the PRIMA/ENGOT-OV26/GOG-3012 trial. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718223] [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: 10/23/2022] Open
Affiliation(s)
- F Heitz
- Kliniken Essen-Mitte, Department for Gynecology and Gynecologic Oncology
| | - B Pothuri
- Gynecologic Oncology Group (GOG) and Perlmutter Cancer Center, NYU Langone Health, Department of Obstetrics/Gynecology
| | - S Han
- University Hospitals Leuven, Department of Obstetrics and Gynecology
| | - D Chase
- Arizona Oncology (US Oncology Network), University of Arizona College of Medicine
| | | | - L Gaba
- Hospital Clinic de Barcelona, Medical Oncology Department
| | - L Van Le
- University of North Carolina at Chapel Hill, Department of Ob/Gyn, Division of Gynecologic Oncology
| | - E Guerra
- Hospital Ramon y Cajal, Medical Oncology Department, Breast and Gynecological Cancer Unit
| | - D Bender
- University of Iowa, Department of Obstetrics and Gynecology
| | - J Korach
- The Chaim Sheba Medical Center, Sackler Medical School Tel Aviv University, Department of Oncology
| | | | - P Follana
- GINECO and Centre Antoine Lacassagne
| | - JF Baurain
- Université Catholique de Louvain and Cliniques Universitaires Saint-Luc
| | - C Pisano
- Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Department of Urology and Gynecology
| | - U Peen
- Herlev University Hospital
| | | | | | | | - A González-Martin
- Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Clínica Universidad de Navarra, Medical Oncology Department
| | - BJ Monk
- Arizona Oncology (US Oncology Network), University of Arizona College of Medicine
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Eakin C, Ewongwo A, Chase D, Monk B. A Qualitative Evaluation of Clinical Burden of Poly (ADP-ribose) Polymerase Inhibitor Usage in a Community Oncology Practice. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2019.11.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Fujiwara K, Shapira-Frommer R, Alexandre J, Monk B, Fehm T, Colombo N, Caceres M, Hasegawa K, Dubot C, Li J, Stein K, Keefe S, Tewari K. KEYNOTE-826: A phase III randomized study of chemotherapy with or without pembrolizumab for first-line treatment of persistent, recurrent, or metastatic cervical cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz426.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fujiwara K, Chou HH, Kim JW, Tan D, Tamura K, Katsumata N, Harano K, Hasegawa K, Hume S, Jones E, Goble S, Sullivan L, Shih D, Coleman R, McNeish I, Monk B, Kristeleit R. ATHENA (GOG-3020/ENGOT-ov45): A randomised, double-blind, placebo-controlled phase III study of the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib + the PD-1 inhibitor nivolumab following frontline platinum-based chemotherapy in ovarian cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz426.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Silvas K, O'Neill J, Monk B, Schorr R, Kamaleswaran R. 114 Emergency Department Factors Associated With Early Rapid Responses Activation After Admission. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Moore K, Oza A, Colombo N, Oaknin A, Scambia G, Lorusso D, Farias-Eisner R, Banerjee S, Murphy C, Tanyi J, Hirte H, Konner J, Lim P, Hayes MP, Monk B, Kim S, Wang J, Pautier P, Vergote I, Birrer M. FORWARD I (GOG 3011): A phase III study of mirvetuximab soravtansine, a folate receptor alpha (FRa)-targeting antibody-drug conjugate (ADC), versus chemotherapy in patients (pts) with platinum-resistant ovarian cancer (PROC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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13
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Buechel M, Herzog TJ, Westin SN, Coleman RL, Monk BJ, Moore KN. Treatment of patients with recurrent epithelial ovarian cancer for whom platinum is still an option. Ann Oncol 2019; 30:721-732. [PMID: 30887020 PMCID: PMC8887593 DOI: 10.1093/annonc/mdz104] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [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] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Ovarian cancer remains the most deadly gynecologic cancer with the majority of patients relapsing within 3 years of diagnosis. Traditional treatment paradigms linked to platinum sensitivity or resistance are currently being questioned in the setting of new diagnostic methods and treatment options. DESIGN Authors carried out review of the literature on key topics in treatment of recurrent epithelial ovarian cancer (EOC) when platinum is still an option; including secondary surgical cytoreduction, chemotherapy, novel treatment options, and maintenance therapy. A treatment algorithm is proposed. RESULTS Molecular characterization of EOC is critical to help guide treatment decisions. The role of secondary cytoreductive surgery is currently being evaluated with results from Gynecologic Oncology Group (GOG) 213 and anticipated results from DESKTOP III clinical trials. Chemotherapy backbone has remained relatively unchanged but utilizing non-platinum-based regimens is under investigation. In addition, maintenance therapy with anti-angiogenic therapy and Poly (ADP-ribose) Polymerase (PARP) inhibitors has emerged as the standard of care. Novel combinations, including immunotherapy and anti-angiogenesis agents, may further change the current landscape. CONCLUSIONS The treatment of recurrent EOC is rapidly changing. Clinical trial design will need to continue to evolve as many novel therapies move to the upfront setting. Ultimately, the treatment of patients with recurrent EOC must incorporate individual patient and tumor factors.
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Affiliation(s)
- M Buechel
- Section of Gynecologic Oncology, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City.
| | - T J Herzog
- Division of Gynecologic Oncology, University of Cincinnati Cancer Institute, University of Cincinnati, Cincinnati
| | - S N Westin
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston
| | - R L Coleman
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston
| | - B J Monk
- Division of Gynecologic Oncology, Arizona Oncology, Phoenix, USA
| | - K N Moore
- Section of Gynecologic Oncology, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City
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14
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Vercellino GF, Erdemoglu E, Lichtenberg P, Muallem MZ, Richter R, Abu-Rustum NR, Plante M, Lécuru F, Greggi S, Monk BJ, Sagae S, Denkert C, Keller M, Alhakeem M, Hellriegel M, Dückelmann AM, Chiantera V, Sehouli J. A GCIG international survey: clinical practice patterns of sentinel lymph node biopsies in cervical cancer. Arch Gynecol Obstet 2019; 300:191-199. [PMID: 31006839 DOI: 10.1007/s00404-019-05164-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 12/31/2018] [Accepted: 04/12/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE To evaluate the practice patterns among centers and physicians worldwide regarding sentinel lymph node biopsies (SLNB) in cervical cancer (CC) patients. METHOD A validated 35-item questionnaire regarding SLNB in CC supported by the Gynecologic Cancer Intergroup (GCIG), and sponsored by the North-Eastern German Society of Gynaecologic-Oncology (NOGGO) was sent to all major gynecological cancer societies across the globe for further distribution from October 2015 and continued for a period of 7 months. RESULTS One hundred and sixty-one institutions from around the world participated. One hundred and six (66%) of the participants were from university centers and 111 (69%) were gynecologic oncologists. One hundred and fifty-two (97%) performed lymphadenectomy (LNE) and 147 (94%) did so systematically; 97 (60%) used SLNB, due to lower morbidity (73%), reliability (55%) and time-saving (27%). In cases of positive SLNB (pN+), 39% of respondents stopped the operation and sent the patient for chemoradiation (CRT), 45% completed pelvic and paraaortic LNE, whereas 26% went on to perform a radical hysterectomy (RH) and systematic pelvic and paraaortic LNE. In case of negative SLNB (pN0), 39% of institutions still performed a systematic pelvic and paraaortic LNE. CONCLUSION In this survey worldwide, SLNB adoption is an encouraging 60%, yet ample differences exist regarding strategy, and to a lower extent the techniques used. Lack of experience is the most common reason SLNB is not performed. Efforts to increase surgical education on SLNB technique and multicenter prospective trials providing evidence-based guidelines are warranted.
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Affiliation(s)
- G F Vercellino
- Department of Gynecology With Center for Oncological Surgery, Charité Universtitätmedizin, Charité Platz 1, 10117, Berlin, Germany. .,UMG Universität Medizin Göttingen, 37075, Göttingen, Germany.
| | - E Erdemoglu
- Department of Gynecologic Oncology, Suleyman Demirel University, Isparta, Turkey
| | - P Lichtenberg
- Department of Gynecology With Center for Oncological Surgery, Charité Universtitätmedizin, Charité Platz 1, 10117, Berlin, Germany
| | - M Z Muallem
- Department of Gynecology With Center for Oncological Surgery, Charité Universtitätmedizin, Charité Platz 1, 10117, Berlin, Germany
| | - R Richter
- Department of Gynecology With Center for Oncological Surgery, Charité Universtitätmedizin, Charité Platz 1, 10117, Berlin, Germany
| | - N R Abu-Rustum
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - M Plante
- Division of Gynecologic Oncology, Centre Hospitalier Universitaire de Laval Québec, Quebec, Canada
| | - F Lécuru
- Department of Gynecologic Oncologic and Breast Surgery, Hôpital Européen Georges Pompidou (HEGP), Paris, France.,Université Paris Descartes, Paris, France
| | - S Greggi
- Gynecologic Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori di Napoli, Naples, Italy
| | - B J Monk
- University of Arizona Cancer Center-Phoenix, Creighton University School of Medicine at St Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - S Sagae
- Department of Gynecologic Oncology, Sapporo West Kojinkai Clinic, Sapporo, Japan
| | - C Denkert
- Department of Pathology, Charité Universtitätmedizin, Berlin, Germany
| | - M Keller
- Department of Gynecology With Center for Oncological Surgery, Charité Universtitätmedizin, Charité Platz 1, 10117, Berlin, Germany
| | - M Alhakeem
- Department of Gynecology With Center for Oncological Surgery, Charité Universtitätmedizin, Charité Platz 1, 10117, Berlin, Germany.,Obstetrics and Gynaecology Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - M Hellriegel
- Clinic for Obstetrics and Gynecology, UMG Universitätmedizin, Göttingen, Germany
| | - A M Dückelmann
- Department of Gynecology With Center for Oncological Surgery, Charité Universtitätmedizin, Charité Platz 1, 10117, Berlin, Germany
| | - V Chiantera
- Department of Gynecologic Oncology, University of Palermo, Palermo, Italy
| | - Jalid Sehouli
- Department of Gynecology With Center for Oncological Surgery, Charité Universtitätmedizin, Charité Platz 1, 10117, Berlin, Germany. .,ESGO Center of Excellence Ovarian Cancer Surgery, ESGO Accredited European Training Centre in Gynaecological Oncology, Charité Comprehensive Cancer Center (CCCC), Universitätsmedizin Berlin Charité/Medical University of Berlin, Augustenburger Platz 1, Mittelallee 9, 1st Floor, Room No. 1.3073, 13353, Berlin, Germany.
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Barnes D, Rivera R, Gibson S, Craig C, Cragun J, Monk B, Chase D. The utility of patient reported data in a gynecologic oncology clinic. Gynecol Oncol Res Pract 2018; 5:4. [PMID: 30009038 PMCID: PMC6044081 DOI: 10.1186/s40661-018-0062-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 06/27/2018] [Indexed: 12/04/2022]
Abstract
BACKGROUND Measuring QoL is essential to the field of gynecologic oncology but there seems to be limited standardized data regarding collecting QoL assessments throughout a patient's cancer treatment especially in non-clinical trial patients. The aim of this study is to explore patient characteristics that may be associated with poor quality of life (QoL) in women with gynecologic cancers at two University of Arizona Cancer Center (UACC) sites. METHODS A cross-sectional survey was conducted among English speaking women with gynecologic malignancies at the University of Arizona Cancer Centers in Phoenix and Tucson from April 2012 to July 2015. The survey was a paper packet of questions that was distributed to cancer patients at the time of their clinic visit. The packet contained questions on demographic information, treatment, lifestyle characteristics, pelvic pain and Health-related quality of life (HRQoL). Measures included the generic and cancer-specific scores on the Functional Assessment of Cancer Therapy-General (FACT-G) and the Female Genitourinary Pain Index (GUPI). The total scores and subdomains were compared with descriptive variables (age, body mass index (BMI), diet, exercise, disease status, treatment and support group attendance) using Cronbach alpha (α), Spearman rank correlations (ρ), and Holm's Bonferroni method. RESULTS One-hundred and forty-nine women completed the survey; 55% (N = 81) were older than 60 years, 38% (N = 45) were obese (BMI > 30), 46% (N = 66) exercised daily, and 84% (N = 111) ate one or more daily serving of fruit and vegetables. Women in remission, those who exercised daily and ate fruits/vegetables were less likely to have their symptoms impact their QoL. Younger women were more likely to report genitourinary issues (p = - 0.22) and overall problems with QoL (p = - 0.29) than older women. Among FACT-G support group responses, we found those that did not attend support groups had a significantly higher emotional wellbeing (p = 0.05). CONCLUSIONS This study identified potential areas of clinical focus, which aid in understanding our approach to caring for gynecologic cancer patients and improvement of their HRQoL. We identified that age, pelvic pain, and lifestyle characteristics have indicators to poor QoL in women with gynecologic cancers. In this population, younger women and those with pelvic pain complaints, poor diet and exercise habits should be targeted early for supportive care interventions to improve QoL throughout both treatment and survivorship.
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Affiliation(s)
- D. Barnes
- Department of Gynecologic Oncology, Creighton University School of Medicine at St. Joseph’s Hospital and Medical Center, Phoenix, AZ USA
| | - R. Rivera
- Department of Gynecologic Oncology, Creighton University School of Medicine at St. Joseph’s Hospital and Medical Center, Phoenix, AZ USA
| | - S. Gibson
- University of Arizona Cancer Center, Tucson, AZ USA
| | - C. Craig
- Department of Gynecologic Oncology, Creighton University School of Medicine at St. Joseph’s Hospital and Medical Center, Phoenix, AZ USA
| | - J. Cragun
- University of Arizona Cancer Center, Tucson, AZ USA
| | - B. Monk
- Department of Gynecologic Oncology, Creighton University School of Medicine at St. Joseph’s Hospital and Medical Center, Phoenix, AZ USA
| | - D. Chase
- Department of Gynecologic Oncology, Creighton University School of Medicine at St. Joseph’s Hospital and Medical Center, Phoenix, AZ USA
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Matulonis UA, Monk BJ. PARP inhibitor and chemotherapy combination trials for the treatment of advanced malignancies: does a development pathway forward exist? Ann Oncol 2018; 28:443-447. [PMID: 28057663 DOI: 10.1093/annonc/mdw697] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- U A Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - B J Monk
- Arizona Oncology (US Oncology Network), University of Arizona and Creighton University Phoenix, Phoenix, AZ, USA
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Phippen NT, Secord AA, Wolf S, Samsa G, Davidson B, Abernethy AP, Cella D, Havrilesky LJ, Burger RA, Monk BJ, Leath CA. Quality of life is significantly associated with survival in women with advanced epithelial ovarian cancer: An ancillary data analysis of the NRG Oncology/Gynecologic Oncology Group (GOG-0218) study. Gynecol Oncol 2017; 147:98-103. [PMID: 28743369 DOI: 10.1016/j.ygyno.2017.07.121] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 02/22/2017] [Revised: 07/07/2017] [Accepted: 07/10/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Evaluate association between baseline quality of life (QOL) and changes in QOL measured by FACT-O TOI with progression-free disease (PFS) and overall survival (OS) in advanced epithelial ovarian cancer (EOC). METHODS Patients enrolled in GOG-0218 with completed FACT-O TOI assessments at baseline and at least one follow-up assessment were eligible. Baseline FACT-O TOI scores were sorted by quartiles (Q1-4) and outcomes compared between Q1 and Q2-4 with log-rank statistic and multivariate Cox regression adjusting for age, stage, post-surgical residual disease size, and performance status (PS). Trends in FACT-O TOI scores from baseline to the latest follow-up assessment were evaluated for impact on intragroup (Q1 or Q2-4) outcome by log-rank analysis. RESULTS Of 1152 eligible patients, 283 formed Q1 and 869 formed Q2-4. Mean baseline FACT-O TOI scores were 47.5 for Q1 vs. 74.7 for Q2-4 (P<0.001). Q1 compared to Q2-4 had worse median OS (37.5 vs. 45.6months, P=0.001) and worse median PFS (12.5 vs. 13.1months, P=0.096). Q2-4 patients had decreased risks of disease progression (HR 0.974, 95% CI 0.953-0.995, P=0.018), and death (HR 0.963, 95% CI 0.939-0.987, P=0.003) for each five-point increase in baseline FACT-O TOI. Improving versus worsening trends in FACT-O TOI scores were associated with longer median PFS (Q1: 12.7 vs. 8.6months, P=0.001; Q2-4: 16.7 vs. 11.1months, P<0.001) and median OS (Q1: 40.8 vs. 16months, P<0.001; Q2-4: 54.4 vs. 33.6months, P<0.001). CONCLUSIONS Baseline FACT-O TOI scores were independently prognostic of PFS and OS while improving compared to worsening QOL was associated with significantly better PFS and OS in women with EOC.
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Affiliation(s)
- N T Phippen
- Gynecologic Oncology Service, Department of Obstetrics and Gynecology, Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - A A Secord
- Division of Gynecologic Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - S Wolf
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA
| | - G Samsa
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA
| | - B Davidson
- Division of Gynecologic Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - A P Abernethy
- Duke Clinical Research Institute, Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - D Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Robert H. Lurie Cancer Center, Chicago, IL, USA
| | - L J Havrilesky
- Division of Gynecologic Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - R A Burger
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - B J Monk
- Arizona Oncology (US Oncology Network), University of Arizona, Phoenix, AZ, USA; Creighton University, USA
| | - C A Leath
- University of Alabama at Birmingham, Division of Gynecologic Oncology, Birmingham, AL, USA.
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Abstract
Angiogenesis plays a pivotal role in normal ovarian physiology as well as in the progression of ovarian cancer through ascites formation and metastatic spread. Bevacizumab (Avastin(®), Genentech; South San Francisco, CA, USA), a humanized anti-vascular endothelial growth factor (VEGF) monoclonal antibody, is the most widely studied anti-angiogenesis agent both across tumor types and specifically in epithelial ovarian cancer. In 2005, single-agent bevacizumab at 15 mg/kg (IV) every 3 weeks was first reported to be active in a case of recurrent high-grade serous ovarian cancer after failing 11th line cytotoxic treatment. Since then, many case series, phase II and phase III trials have confirmed these results leading to regulatory approval in most countries including the US Food and Drug Administration in 2014. Guidelines now give clear recommendations as to when and how bevacizumab should be integrated into the ovarian cancer treatment paradigm. Other anti-VEGF agents such as the VEGF receptor (VEGFR) tyrosine kinase inhibitors have not shown increased activity or reduced toxicity relative to bevacizumab. However, anti-angiogenics other than anti-VEGF/VEGFR agents such as those targeting Angiopoietin-1 and -2 are in development as well as novel combinations with vascular disrupting agents (VDAs), PARP inhibitors and immune checkpoint inhibitors. Clearly, the benefits of anti-angiogenic agents such as bevacizumab must be carefully weighed against the cost and associated toxicities. Although almost all patients with ovarian cancer will receive an anti-angiogenic compound, cures are not increased. Predictive biomarkers are an urgent unmet need.
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Affiliation(s)
- B J Monk
- Division of Gynecologic Oncology, The University of Arizona Cancer Center, Creighton University School of Medicine at St Joseph's Hospital and Medical Center, Phoenix
| | - L E Minion
- Division of Gynecologic Oncology, The University of Arizona Cancer Center, Creighton University School of Medicine at St Joseph's Hospital and Medical Center, Phoenix
| | - R L Coleman
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
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Tewari KS, Java JJ, Eskander RN, Monk BJ, Burger RA. Early initiation of chemotherapy following complete resection of advanced ovarian cancer associated with improved survival: NRG Oncology/Gynecologic Oncology Group study. Ann Oncol 2015; 27:114-21. [PMID: 26487588 DOI: 10.1093/annonc/mdv500] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [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: 07/18/2015] [Accepted: 10/09/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND To determine whether time from surgery to initiation of chemotherapy impacts survival in advanced ovarian carcinoma. PATIENTS AND METHODS This is a post-trial ad hoc analysis of Gynecologic Oncology Group protocol 218, a phase III randomized, double-blind, placebo-controlled trial designed to study the antiangiogenesis agent, bevacizumab, in primary and maintenance therapy for patients with newly diagnosed advanced ovarian carcinoma. Maximum attempt at debulking was an eligibility criterion. Stage III patients, not stage IV, were required to have gross macroscopic or palpable residual disease following surgery. The survival impact of time from surgery to initiation of chemotherapy was studied using Cox regression models and stratified by treatment arm, residual disease and other clinical and pathologic factors. RESULTS One thousand seven hundred eighteen assessable patients were randomized (stage III (n = 1237); stage IV (n = 477), including those with complete resection (stage IV only, n = 81), low-volume residual (≤1 cm, n = 701), and suboptimal (>1 cm, n = 932). On multivariate analysis, time to chemotherapy initiation was predictive of overall survival (P < 0.001), with the complete resection group (i.e. stage IV) encountering an increased risk of death when time to initiation of chemotherapy exceeded 25 days (95% confidence interval 16.6-49.9 days). CONCLUSION Survival for women with advanced ovarian cancer may be adversely affected when initiation of chemotherapy occurs >25 days following surgery. Our analysis applies to stage IV only as women with stage III who underwent complete resection were not eligible for this trial. These results, however, are consistent with Gompertzian first-order kinetics where patients with microscopic residual are most vulnerable. CLINICAL TRIALS IDENTIFIER NCT00262847.
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Affiliation(s)
- K S Tewari
- University of California, Irvine Medical Center, Orange, California
| | - J J Java
- NRG Oncology/Gynecologic Oncology Group Statistics and Data Management Center, Roswell Park Cancer Institute, Buffalo
| | - R N Eskander
- University of California, Irvine Medical Center, Orange, California
| | - B J Monk
- Creighton University School of Medicine, St Joseph's Hospital and Medical Center, Phoenix
| | - R A Burger
- Obstetrics and Gynecology, University of Pennsylvania, Pennsylvania, USA
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Minion L, Chase D, Farley J, Willmott L, Monk B. Safety and efficacy of salvage nano-particle albumin bound paclitaxel in recurrent cervical cancer: A feasibility study. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.07.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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22
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Shields K, Minion L, Sumner D, Monk B. Ten year food and drug administration reporting of robot-assisted laparoscopy complications, deaths, and device malfunctions in gynecologic surgery. Gynecol Oncol 2014. [DOI: 10.1016/j.ygyno.2014.07.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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23
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Monk BJ, Pujade-Lauraine E, Burger RA. Integrating bevacizumab into the management of epithelial ovarian cancer: the controversy of front-line versus recurrent disease. Ann Oncol 2014; 24 Suppl 10:x53-x58. [PMID: 24265406 DOI: 10.1093/annonc/mdt472] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [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: 01/24/2023] Open
Abstract
Angiogenesis plays a fundamental role in the pathogenesis of ovarian cancer. Vascular endothelial growth factor (VEGF) expression has been associated with the development of malignant ascites and tumor progression. Bevacizumab (Avastin(®); Genentech, South San Francisco, CA, USA), a humanized anti-VEGF monoclonal antibody, is the most widely studied antiangiogenesis agent across tumor types and specifically in epithelial ovarian cancer (EOC). With the recent reporting of four consecutive positive randomized trials adding bevacizumab to chemotherapy in the treatment of both front-line (GOG 218 and ICON7) and recurrent EOC ['platinum-resistant' (AURELIA Trial) or 'platinum-sensitive' (OCEANS Trial)], the most debatable question today is thus not IF we should treat ovarian cancer patients with bevacizumab, but WHEN. As bevacizumab is active in both settings, it seems appropriate to carefully consider this clinical controversy: 'what is the optimal setting for bevacizumab treatment?' A fine balance of efficacy, toxicity, quality of life, and symptom control is the main crux of this controversy. The cost effectiveness of bevacizumab in EOC is also controversial.
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Affiliation(s)
- B J Monk
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The University of Arizona Cancer Center, Creighton University School of Medicine at St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
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duPont N, Brady M, Burger R, Monk B. Prognostic significance of ethnicity and age in advanced stage ovarian cancer: An analysis of GOG 218. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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25
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Lin J, Berger J, Krivak T, Beriwal S, Chan J, Sukumvanich P, Monk B, Richard S. The impact of facility volume on receiving standard of care therapy for locally-advanced cervical cancer: A National Cancer Data Base study. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Tewari K, Sill M, Monk B, Long H, Ramondetta L, Landrum L, Oaknin A, Reid T, Leitao M, Michael H. Phase III randomized clinical trial of cisplatin plus paclitaxel vs the non-platinum chemotherapy doublet of topotecan plus paclitaxel in women with recurrent, persistent, or advanced cervical carcinoma: A Gynecologic Oncology Group study. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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27
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Craig C, Lin C, Fedewa S, Virgo K, Farley J, Monk B, Chase D. Therapeutic choices and outcomes in vulvar cancer cases reported by the National Cancer Database Registry. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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28
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Coleman R, Burger R, Brady M, Bookman M, Fowler J, Birrer M, Fleming G, Mannel R, Monk B. Analysis of survivorship in high-risk patients on treated on GOG-218. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.326] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tewari D, Java J, Salani R, Armstrong D, Markman M, Herzog T, Monk B, Chan J. Long-term survival advantage of intraperitoneal chemotherapy treatment in advanced ovarian cancer: An analysis of a Gynecologic Oncology Group ancillary data study. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Randall L, Burger R, Nguyen H, Kong G, Bookman M, Fleming G, Monk B, Mannel R, Birrer M. Time from completion of chemotherapy to disease progression as a clinically relevant endpoint in women with epithelial ovarian, primary peritoneal, and fallopian tube cancers treated with and without bevacizumab. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Jordan SM, Chase DM, Watanabe T, Osann K, Monk BJ, Rutgers JKL. High pathologic misdiagnosis of cervical adenocarcinoma in situ. EUR J GYNAECOL ONCOL 2013; 34:446-449. [PMID: 24475580] [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: 06/03/2023]
Abstract
OBJECTIVE The objectives of this research were to evaluate cases of adenocarcinoma in situ (AIS) and early invasive adenocarcinoma (AC) of the uterine cervix in order to: (1) calculate the pathologic discordance between initial biopsies and final surgical excision specimens and (2) describe the clinical and pathologic factors associated with discordance. MATERIALS AND METHODS The University of California, Irvine and Long Beach Memorial tumor registries were used to identify 105 women with AIS and early AC treated between 1990 and 2008. The primary endpoint measured was change in diagnosis when comparing pathology from the initial biopsy to specimens from a large loop excision of the transformation zone (LLETZ), cold knife cone (CKC), or hysterectomy. The variables studied were: age, endocervical curettage (ECC), co-existing cervical intraepithelial neoplasia (CIN), race, and insurance type, as surrogates for socioeconomic status. RESULTS Initial biopsies were diagnosed as AIS and AC in 44% and 56% of patients, respectively. Of the patients with a biopsy diagnosis ofAIS, 29% had a final diagnosis of AC after excisional procedure, and this discordance was not associated with any of the factors studied. CONCLUSIONS A concerning high rate of discordance between colposcopic-guided punch biopsy and final pathology reinforces the current guidelines to always perform an excisional biopsy following diagnosis of AIS on punch biopsy.
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Affiliation(s)
- S M Jordan
- Department of Gynecologic Oncology and Internal Medicine, University of California, Irvine, CA, USA
| | - D M Chase
- Department of Gynecologic Oncology and Internal Medicine, University of California, Irvine, CA, USA
| | - T Watanabe
- Undergraduate Studies, University of California, Irvine, CA, USA
| | - K Osann
- Department of Gynecologic Oncology and Internal Medicine, University of California, Irvine, CA, USA
| | - B J Monk
- Division of Gynecologic Oncology, Creighton University School of Medicine, Omaha, NE, USA
| | - J K L Rutgers
- Department of Pathology, Long Beach Memorial Medical Center, Long Beach, CA 90806, USA
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Abstract
Polymorphism of the human papillomavirus type 16 (HPV-16) genome has been reported to occur within the noncoding regulatory long control region (LCR) and in the E7 and L1 genes. The current study focuses on the HPV-16 E6 oncogene which interacts with the antioncogenic regulator p53. Seventy-eight HPV-16-positive DNA samples derived from cervical carcinomas were screened for the presence of polymorphism in the HPV-16 E6 gene by polymerase chain reaction (PCR) linked single stranded conformational polymorphism (SSCP) analysis. Nine DNA samples had heterozygous mutations within the same region of the E6 gene 3' terminus; T to C transitions at HPV-16 position 511 (silent) and one of the nine also had a 513 mutation (Met to Thr). These mutations correlated with the clinical aggressiveness of the tumor, suggesting that the presence of these mutations may be due to genomic instability of advanced cervical carcinoma.
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Affiliation(s)
- R Burger
- NCI,BIOL LAB,BETHESDA,MD 20892. CITY HOPE NATL MED CTR,DEPT PATHOL,DUARTE,CA 91010. UNIV CALIF IRVINE,UCI MED CTR,CTR CLIN CANC,DEPT OBSTET & GYNECOL,DIV GYNECOL ONCOL,ORANGE,CA 92717
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Amanam I, Kiet T, Young-Lin N, Chen L, Brooks R, Ueda S, Monk B, Kapp D, Hoth D, Chan J. Predictive model for cancer drug approval – An analysis of FDA drug submissions over the last decade. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Amanam I, Kiet T, Young-Lin N, Chen L, Brooks R, Ueda S, Monk B, Kapp D, Hoth D, Chan J. Applications for oncologic drugs — Lessons from the oncologic drug advisory committee. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Eskander R, Ali S, Lankes H, Dellinger T, Hoang B, Ramirez N, Monk B, Walker J, Eisenhauer E, Randall L. Expression patterns of the Wnt pathway inhibitor dickKOPF-3 (Dkk3) and secreted frizzled-related proteins (sFRP) 1 and 4 in endometrial endometrioid adenocarcinoma: A gynecologic oncology group study. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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36
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Chan J, Java J, Monk B, Alvarez-Secord A, Kapp D, Birrer M, Aghajanian C, Bookman M, Kattan M, Burger R. A practical prediction model for determining bevacizumab response and toxicity in the treatment of advanced ovarian and peritoneal cancers – An analysis of GOG 218. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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37
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Chan J, Kiet T, Sherman A, Monk B, Kapp D. The association of VEGF A, B, and C expression in the survival of serous ovarian cancer patients. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Chan J, Kiet T, Chen L, Ruskin R, Sherman A, Lesnock J, Monk B, Kapp D, Krivak T. Chemotherapy response and survival in serous ovarian cancer patients with BRCA mutations. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lesnock J, Chan J, Kiet T, Sherman A, Monk B, Ruskin R, Kapp D, Chen L, Krivak T. BRCA mutations and advanced stage serous epithelial ovarian cancer—Does the type of mutation matter? Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Dellinger T, Eskander R, Ali S, Lankes H, Randall L, Ramirez N, Monk B, Walker J, Eisenhauer E, Hoang B. Expression patterns of the Wnt pathway inhibitors Dickkopf3 (Dkk3) and secreted frizzled-related proteins (SFRP) 1 and 4 in endometrial endometrioid adenocarcinoma: A Gynecologic Oncology Group study. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Velasco AP, Monk B, Kaye S, Vermorken J, Nieto A, Gomez J, Park Y, Parekh T, Colombo N, Vergote I. 8031 POSTER Prediction of Overall Survival (OS) Adjusted by Continuous Platinum-free Interval (PFI) at Fixed Timepoints in Patients With Recurrent Ovarian Cancer (ROC) – Results From OVA-301. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72119-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Chan J, Monk B, Fuh K, Urban R, Hu L, Caughey A, Yu X. An economic analysis of bevacizumab in recurrent treatment of ovarian cancer. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chan J, Kiet T, Sherman A, Fuh K, Ueda S, Brooks R, Kapp D, Chen L, Monk B. MicroRNA as a novel predictor of response to bevacizumab in recurrent serous ovarian cancer: An analysis of The Cancer Genome Atlas. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Chase D, Sill M, Chambers M, Darcy K, Han E, Fruehauf J, Monk B, Buening B, Sorosky J, Burger R. Changes in tumor blood flow as estimated by dynamic-contrast MRI may predict activity of single-agent bevacizumab in recurrent epithelial ovarian cancer and primary peritoneal cancer: An exploratory analysis of a Gynecologic Oncology Group phase II trial. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Burger R, Brady M, Bookman M, Monk B, Walker J, Homesley H, Fowler J, Greer B, Boente M, Liang S. Prospective investigation of risk factors for gastrointestinal adverse events in a phase III randomized trial of bevacizumab in first-line therapy of advanced epithelial ovarian cancer, primary peritoneal cancer or fallopian tube cancer: A Gynecologic Oncology Group study. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [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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Fuh K, Chan J, Monk B, Urban R, Hu L, Kapp D, Caughey A, Yu X. Is it more cost-effective to use bevacizumab in the primary treatment setting or at recurrence? An economic analysis. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kaye SB, Colombo N, Monk BJ, Tjulandin S, Kong B, Roy M, Chan S, Filipczyk-Cisarz E, Hagberg H, Vergote I, Lebedinsky C, Parekh T, Santabárbara P, Park YC, Nieto A, Poveda A. Trabectedin plus pegylated liposomal doxorubicin in relapsed ovarian cancer delays third-line chemotherapy and prolongs the platinum-free interval. Ann Oncol 2011; 22:49-58. [PMID: 20643863 PMCID: PMC3003617 DOI: 10.1093/annonc/mdq353] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [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: 04/19/2010] [Revised: 05/10/2010] [Accepted: 05/12/2010] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND OVA-301 is a large randomized trial that showed superiority of trabectedin plus pegylated liposomal doxorubicin (PLD; CentoCor Ortho Biotech Products L.P., Raritan, NJ, USA). over single-agent PLD in 672 patients with relapsed ovarian cancer, particularly in the partially platinum-sensitive subgroup [platinum-free interval (PFI) of 6-12 months]. This superiority has been suggested to be due to the differential impact of subsequent (platinum) therapy. PATIENTS AND METHODS a detailed analysis of subsequent therapies and survival outcomes in the overall population and in the subsets according to platinum sensitivity was therefore conducted. RESULTS similar proportions of patients received subsequent therapy in each arm (76% versus 77%), including further platinum-based regimens (49% versus 55%). Patients in the trabectedin/PLD arm received subsequent chemotherapy at a later time (median delay 2.5 months versus PLD arm). Overall survival from subsequent platinum was significantly prolonged in the partially platinum-sensitive disease subset (hazard ratio = 0.63; P = 0.0357). CONCLUSION the superiority of trabectedin/PLD over single-agent PLD in OVA-301 cannot be explained by differences in the extent or nature of subsequent therapies administered to these patients. On the other hand, these exploratory analyses support the hypothesis that the enhanced survival benefits in the partially platinum-sensitive subset might be due to an extended PFI leading to longer survival with subsequent platinum.
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Affiliation(s)
- S B Kaye
- Section of Medicine, Institute of Cancer Research, The Royal Marsden Hospital, Sutton, Surrey, UK.
| | - N Colombo
- Medical Gynecologic Oncology Unit, European Institute of Oncology, Milan, Italy
| | - B J Monk
- Division of Gynecological Oncology, Department of Obstetrics and Gynecology, University of California Irvine Medical Center, Orange, CA, USA
| | - S Tjulandin
- Department of Clinical Pharmacology and Chemotherapy, Russian Cancer Research Center, Moscow, Russia
| | - B Kong
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Ji'nan, Shandong, China
| | - M Roy
- Department of Gynecologic Oncology, University Hospital Center, Quebec, Canada
| | - S Chan
- Department of Clinical Oncology, Nottingham University Hospital, Nottingham, UK
| | | | - H Hagberg
- Department of Oncology, Akademiska Sjukhuset, Uppsala, Sweden
| | - I Vergote
- Division of Gynecological Oncology, Department of Obstetrics and Gynecology, University Hospital, Leuven, Belgium
| | - C Lebedinsky
- Clinical R&D and Medical Affairs Department, Pharma Mar, Madrid, Spain
| | - T Parekh
- Johnson & Johnson Pharmaceutical Research & Development, L.L.C., Raritan, NJ, USA
| | - P Santabárbara
- Clinical R&D and Medical Affairs Department, Pharma Mar, Madrid, Spain
| | - Y C Park
- Johnson & Johnson Pharmaceutical Research & Development, L.L.C., Raritan, NJ, USA
| | - A Nieto
- Clinical R&D and Medical Affairs Department, Pharma Mar, Madrid, Spain
| | - A Poveda
- Department of Medical Oncology, Valencian Institute of Oncology, Valencia, Spain
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Poveda A, Vergote I, Tjulandin S, Kong B, Roy M, Chan S, Filipczyk-Cisarz E, Hagberg H, Kaye SB, Colombo N, Lebedinsky C, Parekh T, Gómez J, Park YC, Alfaro V, Monk BJ. Trabectedin plus pegylated liposomal doxorubicin in relapsed ovarian cancer: outcomes in the partially platinum-sensitive (platinum-free interval 6-12 months) subpopulation of OVA-301 phase III randomized trial. Ann Oncol 2011; 22:39-48. [PMID: 20643862 PMCID: PMC3003616 DOI: 10.1093/annonc/mdq352] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [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: 04/19/2010] [Revised: 05/25/2010] [Accepted: 05/25/2010] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND OVA-301 is a large randomized trial that showed superiority of trabectedin plus pegylated liposomal doxorubicin (PLD) over PLD alone in relapsed ovarian cancer. The optimal management of patients with partially platinum-sensitive relapse [6-12 months platinum-free interval (PFI)] is unclear. PATIENTS AND METHODS within OVA-301, we therefore now report on the outcomes for the 214 cases in this subgroup. RESULTS Trabectedin/PLD resulted in a 35% risk reduction of disease progression (DP) or death [hazard ratio (HR) = 0.65, 95% confidence interval (CI), 0.45-0.92; P = 0.0152; median progression-free survival (PFS) 7.4 versus 5.5 months], and a significant 41% decrease in the risk of death (HR = 0.59; 95% CI, 0.43-0.82; P = 0.0015; median survival 23.0 versus 17.1 months). The safety of trabectedin/PLD in this subset mimicked that of the overall population. Similar proportions of patients received subsequent therapy in each arm (76% versus 77%), although patients in the trabectedin/PLD arm had a slightly lower proportion of further platinum (49% versus 55%). Importantly, patients in the trabectedin/PLD arm survived significantly longer after subsequent platinum (HR = 0.63; P = 0.0357; median 13.3 versus 9.8 months). CONCLUSION This hypothesis-generating analysis demonstrates that superior benefits with trabectedin/PLD in terms of PFS and survival in the overall population appear particularly enhanced in patients with partially sensitive disease (PFI 6-12 months).
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Affiliation(s)
- A Poveda
- Area of Gynecologic Oncology, Valencian Institute of Oncology, Valencia, Spain.
| | - I Vergote
- Division of Gynecological Oncology, Department of Obstetrics and Gynecology, University Hospital, Leuven, Belgium
| | - S Tjulandin
- Department of Clinical Pharmacology and Chemotherapy, Russian Cancer Research Center, Moscow, Russia
| | - B Kong
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Ji'nan, Shandong, China
| | - M Roy
- Department of Gynecologic Oncology, University Hospital Center, Quebec, Canada
| | - S Chan
- Department of Clinical Oncology, Nottingham University Hospital, Nottingham, UK
| | | | - H Hagberg
- Department of Oncology, Akademiska Sjukhuset, Uppsala, Sweden
| | - S B Kaye
- Department of Cancer Medicine, The Royal Mardsen Hospital, Sutton, Surrey, UK
| | - N Colombo
- Medical Gynecologic Oncology Unit, European Institute of Oncology, Milan, Italy
| | - C Lebedinsky
- Clinical R&D and Medical Affairs Department, Pharma Mar, Madrid, Spain
| | - T Parekh
- Johnson & Johnson Pharmaceutical Research & Development, L.L.C., Raritan, NJ
| | - J Gómez
- Clinical R&D and Medical Affairs Department, Pharma Mar, Madrid, Spain
| | - Y C Park
- Johnson & Johnson Pharmaceutical Research & Development, L.L.C., Raritan, NJ
| | - V Alfaro
- Clinical R&D and Medical Affairs Department, Pharma Mar, Madrid, Spain
| | - B J Monk
- Division of Gynecological Oncology, Department of Obstetrics and Gynecology, University of California Irvine Medical Center, Orange, CA, USA
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Chan J, Tian C, Yang K, Kesterson J, Kapp D, Monk B, Herzog T, Bell J. The pattern of CA-125 normalization during chemotherapy predicts for recurrence and survival in patients with high-risk early-stage ovarian cancer: A gynecologic oncology group study. Gynecol Oncol 2010. [DOI: 10.1016/j.ygyno.2009.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Poveda A, Kaye S, Herzog T, Ghatage P, Meerpohl H, Ngan H, Emerich J, Tercero J, Ricci D, Monk B. 8005 Correlation of RNA expression of DNA repair genes with clinical outcomes of advanced ovarian cancer (OC) pts treated with pegylated liposomal doxorubicin (PLD) vs Trabectedin (T) + PLD in the ET743-OVA-301 clinical trial. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71527-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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