Extended duration of response with second-line intraperitoneal platinum-based therapy for epithelial ovarian cancer.

Abstract

5073 Background: For epithelial ovarian cancer (EOC), a longer duration of response after second-line intravenous (IV) therapy as compared to first-line (IV) platinum therapy occurs in only 3% of patients (Markman et al., 2004). The purpose of this study was to examine the time to progression interval (TPI) in patients treated with surgery and intraperitoneal (IP) chemotherapy for first recurrence of their disease. Methods: We retrospectively reviewed the medical records at our institution for women treated with second-line IP chemotherapy between January 2005 and April 2010. TPI was defined as the time from the end of previous therapy to the start of next therapy for both first-line and second-line platinum therapy. Results: We identified 56 women who received second-line IP chemotherapy for their EOC recurrence. All patients had previously undergone primary surgical cytoreduction (82.3% were considered optimally cytoreduced) followed by IV platinum-based chemotherapy. The mean age was 56.7 years (range 43-79). All patients underwent secondary cytoreduction at the time of IP port placement for treatment of recurrent disease and 65.3% of patients were considered optimally cytoreduced (< 1 cm residual disease) at the end of the secondary debulking surgery. In 13 patients (23.2%) a longer TPI after second-line IP chemotherapy was observed compared to TPI after primary IV chemotherapy. The median first-line TPI for those 13 women was only 8 months, while median TPI after second-line IP chemotherapy was 24 months. In comparison, the 43 patients with shorter TPI after IP chemotherapy had median TPI of 22.5 mos after first-line IV chemotherapy and 8 months after IP chemotherapy. Conclusions: A longer duration of second-line response was observed in 23.2% of patients treated with IP chemotherapy after IV chemotherapy and the duration of response was clinically significant. The use of IP platinum treatment for recurrent EOC should be further studied in a prospective trial in women who do not do receive front-line IP platinum chemotherapy.