Identifying patients unlikely to benefit from further chemotherapy: A descriptive study of outcome at each relapse in ovarian cancer

Abstract

Objective Not all patients with relapsed ovarian cancer (EOC) benefit from further treatment and thus treatment should be selectively applied. Methods/patients A retrospective review of survival and response outcomes in 120 women with relapsed EOC, all treated at original diagnosis with surgery and platin plus paclitaxel, who had all their initial and subsequent relapse therapy carried out at the BCCA. Results In those patients selected for re-treatment upon relapse, lack of progression rates were 63%, 50%, 45%, 44%, 29%, and 20% respectively for first through sixth relapse. The corresponding median survivals from that relapse were 14, 10, 6, 7, 8, and 5 months. A predictive model based upon the length of the interval between the two preceding relapses (or diagnosis to 2nd relapse) predicted which patients would survive less than 6 months (patient defined “lack of benefit” to chemotherapy criterion): diagnosis to second relapse <12 months; first to third relapse <6 months; second to fourth <6 months; third to fourth <6 months, and fifth to sixth <6 months. Conclusion In selected patients, multiple episodes of re-treatment are of value. A time-based statistic identifies those who will not benefit, defined as survival less than 6 months.