Does the progression-free interval after primary chemotherapy predict survival after salvage chemotherapy in advanced and recurrent endometrial cancer?: a Gynecologic Oncology Group ancillary data analysis.

Abstract

BACKGROUND:

This study evaluated whether progression-free interval (PFI) following primary chemotherapy (PCT) was predictive of overall survival (OS) after second-line chemotherapy in advanced/recurrent endometrial cancer (EC).

METHODS:

This is a pooled analysis of patients who recurred after PCT and were treated with second-line chemotherapy on Gynecologic Oncology Group trials. PFI-1 measured from initiation of PCT to recurrence or treatment-free interval (TFI) measured from completion of PCT to initiation of second-line chemotherapy was evaluated in relation to clinical outcomes.

RESULTS:

A total of 586 patients treated on 5 phase 3 PCT protocols were included. Baseline factors in primary setting associated with clinical outcome after PCT were also predictive of OS after second-line chemotherapy, including race, Gynecologic Oncology Group performance status, grade, and prior radiation therapy (P<.01). PFI-1 was the most significant factor predictive of survival after second-line chemotherapy, with a 30% reduction in the risk of death for PFI-1>6 months compared with ≤6 months (hazard ratio [HR], 0.70; 95% confidence interval [CI], 0.59-0.84 [P<.0001]) and median OS after second-line chemotherapy of 10 versus 5 months. A total of 275 patients treated on 9 phase 2 second-line chemotherapy protocols were also evaluated, and TFI>3 months was associated with a 25% reduction in the risk of death (HR, 0.75; 95% CI, 0.57-0.97 [P=.030]) and median OS after second-line chemotherapy of 10 versus 7 months compared with TFI≤3 months. The tumor response to second-line chemotherapy was 9.6% versus 5.8%; the difference was not statistically significant.

CONCLUSIONS:

Time to recurrence after PCT is predictive of survival after recurrence in advanced/recurrent EC. However, there is no evidence that this variable can be used in selecting salvage chemotherapy.

• Authors: Kathleen N Moore, Chunqiao Tian, D Scott McMeekin, J Tate Thigpen, Marcus E Randall, Holly H Gallion
• Journal: Cancer (Cancer) Vol. 116 Issue 23 Pg. 5407-14 (Dec 01 2010) ISSN: 0008-543X [Print] United States
• PMID: 20737572 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2010 American Cancer Society.

Chemical References

• Antibiotics, Antineoplastic
• Doxorubicin

Topics

• Aged
• Antibiotics, Antineoplastic (therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Clinical Trials, Phase III as Topic
• Disease-Free Survival
• Doxorubicin (therapeutic use)
• Endometrial Neoplasms (drug therapy, mortality, pathology)
• Female
• Humans
• Middle Aged
• Randomized Controlled Trials as Topic
• Recurrence
• Salvage Therapy
• Survival Analysis
• Time Factors