J Gynecol Oncol.  2020 Nov;31(6):e94. 10.3802/jgo.2020.31.e94.

The post-progression survival of patients with recurrent or persistent ovarian clear cell carcinoma: results from a randomized phase III study in JGOG3017/GCIG

Affiliations
  • 1Department of Obstetrics and Gynecology, Mie University School of medicine, Tsu, Japan
  • 2Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan
  • 3Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
  • 4Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
  • 5Department of Obstetrics and Gynecology, Kyushu University School of Medicine, Fukuoka, Japan
  • 6Division of Clinical Research, Global Clinical Research Coordinating Center, Kitasato University, Tokyo, Japan
  • 7Department of Obstetrics and Gynecology, Osaka City General Hospital, Osaka, Japan
  • 8Department of Obstetrics and Gynecology, Saitama Medical University International Medical Center, Hidaka, Japan
  • 9Department of Obstetrics and Gynecology, Kosei General Hospital, Kutchan, Japan
  • 10Department of Obstetrics and Gynecology, Tokyo Medical University School of Medicine, Tokyo, Japan
  • 11Department of Obstetrics and Gynecology, Osaka City University School of Medicine, Osaka, Japan
  • 12Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
  • 13Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
  • 14Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
  • 15Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Japan

Abstract


Objective
In this study we sought to investigate the clinical factors that affect postprogression survival (PPS) in patients with recurrent or persistent clear cell carcinoma (CCC). We utilized the JGOG3017/Gynecological Cancer InterGroup data to compare paclitaxel plus carboplatin (TC) and irinotecan plus cisplatin (CPT-P) in the treatment of stages I to IV CCC.
Methods
We enrolled 166 patients with recurrent or persistent CCC and assessed the impact of variables, including platinum sensitivity, treatment arm, crossover chemotherapy, primary stage, residual tumor at primary surgery, performance status, ethnicity, and tumor reduction surgery at recurrence on the median of PPS in patients with recurrent or persistent CCC.
Results
A total of 77 patients received TC, and 89 patients received CPT-P. The median PPS for patients with platinum-resistant disease was 10.9 months, compared with 18.8 months for patients with platinum-sensitive disease (hazard ratio [HR]=1.88; 95% confidence interval [CI]=1.30–2.72; log-rank p<0.001). In the multivariate analysis, the platinum sensitivity (resistant vs. sensitivity; HR=1.60; p=0.027) and primary stage (p=0.009) were identified as independent predictors of prognosis factors for PPS in recurrent or persistent CCC.
Conclusions
Our findings revealed that platinum sensitivity and primary stage are clinical factors that significantly affect PPS in patients with recurrent or persistent CCC as well as other histologic subtypes of ovarian cancer. PPS in patients with recurrent CCC should establish the basis for future clinical trials in this population.

Keyword

Recurrence; Platinum; Ovarian Cancer; Survival
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