Advanced Ovarian Cancer: 20% Disease-Free Survival at 10 Years

This transcript has been edited for clarity.

I'm Dr Maurie Markman from Cancer Treatment Centers of America. I would like to briefly discuss a very interesting topic that is often discussed in the oncology literature and with patients.

The paper I'm referring to is "What proportion of patients with stage III ovarian cancer are potentially cured following intraperitoneal chemotherapy? Analysis of the long term (≥10 years) survivors in NRG/GOG randomized clinical trials of intraperitoneal and intravenous chemotherapy in stage III ovarian cancer." This paper was published in Gynecologic Oncology in 2022.

The question that is often asked is, what percentage of patients who are treated for advanced ovarian cancer can be anticipated to have their disease respond, achieve a complete response, and then not recur?

This was a very interesting analysis of three very well-done phase 3 randomized trials conducted a number of years ago that asked very similar questions, including the question of intraperitoneal vs intravenous chemotherapy — all platinum based — in the management of advanced ovarian cancer.

Because the studies were actually very similar in terms of their chemotherapy — except for intravenous vs intraperitoneal — and because these patients were followed very carefully for a long period of time, the potential existed to ask, how many patients are alive at 10 years following therapy? How many of those patients are potentially disease free at 10 years, where we can probably begin to ask, are they cured?

In this particular situation, these are three very mature randomized trials. In the three trials, a total of 1174 patients were included, so a very large patient population was randomized. After completion of therapy, and now 10 years later, 26% of these patients were alive. The specific question asked is, what percentage of these patients at 10 years were not only alive but disease free? The answer was 18%.

It is reasonable to conclude, based upon these data from a population of over 1000 patients, that 1 in 5 individuals, or approximately 20%, with advanced ovarian cancer undergoing optimal surgery and optional platinum-based chemotherapy — and this is, of course, before the days of PARP inhibitors or even bevacizumab, which are now widely used — can be anticipated to be disease free at 10 years and very possibly cured of the malignancy.

This is a very important observation, and a very important number and percentage to consider in discussing with your patients the opportunities for disease to respond and not come back.

For those of you interested in this question, I refer you to read this very interesting paper that appeared in Gynecologic Oncology. Thank you for your attention.

Maurie Markman, MD, is president of medicine and science at Cancer Treatment Centers of America in Philadelphia. He has more than 20 years of experience in cancer treatment and gynecologic oncology research.

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Cite this: Advanced Ovarian Cancer: 20% Disease-Free Survival at 10 Years - Medscape - Feb 07, 2023.

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