Reply to M.L. Friedlander et al

Abstract

In a recent letter, Friedlander et al discuss the role of symptom benefit in platinum-resistant or -refractory ovarian cancer. Qualityof-life (QoL) assessments are of extreme importance in this patient population and particularly in this setting of platinum-resistant, recurrent ovarian cancer. For this reason, evaluation of patient-reported symptoms and QoL by the Functional Assessment of Cancer TherapyOvary (FACT-O) and FACT-O Symptom Index were secondary objectives in the phase III study that compared patupilone with pegylated liposomal doxorubicin in this patient population, and the results were published online as supplementary material. As reported, these scores trended lower (suggesting a decrease in the QoL) in the patients in the patupilone arm compared with those in the pegylated liposomal doxorubicin arm. This result is intriguing in that patupilone produced a higher overall response rate compared with pegylated liposomal doxorubicin (15.5% v 7.9%). Thus, although one might expect a possible positive impact on disease-related symptoms, the converse was observed. This may be reflective of the relatively low response rate, which did not translate into an appreciable impact on QoL. Alternatively, the QoL may have been negatively affected by chemotherapyrelated symptoms, which may reflect the unique toxicity profile for patupilone compared with pegylated liposomal doxorubicin. A more in-depth assessment would be required to derive a more definitive conclusion, but as future trials measure and report QoL and symptom benefit assessments, these types of comparative analyses will become increasingly common. Nicoletta Colombo University of Milan-Bicocca and European Institute of Oncology, Milan, Italy