Preference of elderly patients' to oral or intravenous chemotherapy in heavily pre-treated recurrent ovarian cancer: final results of a prospective multicenter trial
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Preference of elderly patients' to oral or intravenous chemotherapy in heavily pre-treated recurrent ovarian cancer: final results of a prospective multicenter trial. / Chekerov, Radoslav; Harter, Philipp; Fuxius, Stefan; Hanker, Lars Christian; Woelber, Linn; Müller, Lothar; Klare, Peter; Abenhardt, Wolfgang; Nedkova, Yoana; Yalcinkaya, Isil; Heinrich, Georg; Sommer, Harald; Mahner, Sven; Wimberger, Pauline; Koensgen-Mustea, Dominique; Richter, Rolf; Oskay-Oezcelik, Gülten; Sehouli, Jalid; Ovarian Cancer Study Group of the North-Eastern Germany Society of Gynecological Oncology (NOGGO).
in: Gynecologic oncology research and practice, Jahrgang 4, 2017, S. 6.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Preference of elderly patients' to oral or intravenous chemotherapy in heavily pre-treated recurrent ovarian cancer: final results of a prospective multicenter trial
AU - Chekerov, Radoslav
AU - Harter, Philipp
AU - Fuxius, Stefan
AU - Hanker, Lars Christian
AU - Woelber, Linn
AU - Müller, Lothar
AU - Klare, Peter
AU - Abenhardt, Wolfgang
AU - Nedkova, Yoana
AU - Yalcinkaya, Isil
AU - Heinrich, Georg
AU - Sommer, Harald
AU - Mahner, Sven
AU - Wimberger, Pauline
AU - Koensgen-Mustea, Dominique
AU - Richter, Rolf
AU - Oskay-Oezcelik, Gülten
AU - Sehouli, Jalid
AU - Ovarian Cancer Study Group of the North-Eastern Germany Society of Gynecological Oncology (NOGGO)
PY - 2017
Y1 - 2017
N2 - BACKGROUND: Palliative systemic treatment in elderly gynaecological cancer patients remains a major challenge. In recurrent ovarian cancer (ROC), treosulfan an active alkylating drug showed similar cytotoxicity whether as oral (p.o.) or intravenous (i.v.) application. The aim of this innovative trial was to evaluate the preference of elderly patients (≥65 years) for p.o. or i.v. chemotherapy focusing compliance, outcome, toxicities, and geriatric aspects as secondary endpoints.METHODS: Patients with ROC had the free choice between treosulfan i.v. (7000 mg/m2d1, q29d) or p.o. (600 mg/m2daily d1-28, q57d). Only indecisive participants were randomized.RESULTS: Overall 123 patients with 2ndto 5threcurrence were registered and 119 received at least one cycle of chemotherapy. 85.7% preferred treosulfan i.v. and 14.3% oral, where only three patients were randomized. Main reasons for i.v. preference associated with individual expectations of lower rate of gastrointestinal disorders, higher activity and tolerability of treatment. Median of applied chemotherapies was three (range 1-12 cycles), with most common grade 3/4 toxicities thrombopenia (18.7%), leukopenia (15.7%), ascites (7.6%), bowel obstruction (6.7%), and abdominal pain (4.2%). Median time until progression/overall survival was 5.2/7.8 months (i.v.), and 5.6/10.4 months (p.o.), respectively, without significant differences in efficacy.CONCLUSIONS: Elderly patients with recurrent ovarian cancer asked and demonstrated active participation in the decision-making process of their oncological treatment and favoured predominantly the i.v. application. Treosulfan was generally well-tolerated despite comorbidities and heavy pre-treatment. Our study demonstrates that patients' preference did not influence prognosis negatively and remains important in gynaecologic oncology decision practice.EUDRACT NR: 2004-000719-25; NCT 00170690.
AB - BACKGROUND: Palliative systemic treatment in elderly gynaecological cancer patients remains a major challenge. In recurrent ovarian cancer (ROC), treosulfan an active alkylating drug showed similar cytotoxicity whether as oral (p.o.) or intravenous (i.v.) application. The aim of this innovative trial was to evaluate the preference of elderly patients (≥65 years) for p.o. or i.v. chemotherapy focusing compliance, outcome, toxicities, and geriatric aspects as secondary endpoints.METHODS: Patients with ROC had the free choice between treosulfan i.v. (7000 mg/m2d1, q29d) or p.o. (600 mg/m2daily d1-28, q57d). Only indecisive participants were randomized.RESULTS: Overall 123 patients with 2ndto 5threcurrence were registered and 119 received at least one cycle of chemotherapy. 85.7% preferred treosulfan i.v. and 14.3% oral, where only three patients were randomized. Main reasons for i.v. preference associated with individual expectations of lower rate of gastrointestinal disorders, higher activity and tolerability of treatment. Median of applied chemotherapies was three (range 1-12 cycles), with most common grade 3/4 toxicities thrombopenia (18.7%), leukopenia (15.7%), ascites (7.6%), bowel obstruction (6.7%), and abdominal pain (4.2%). Median time until progression/overall survival was 5.2/7.8 months (i.v.), and 5.6/10.4 months (p.o.), respectively, without significant differences in efficacy.CONCLUSIONS: Elderly patients with recurrent ovarian cancer asked and demonstrated active participation in the decision-making process of their oncological treatment and favoured predominantly the i.v. application. Treosulfan was generally well-tolerated despite comorbidities and heavy pre-treatment. Our study demonstrates that patients' preference did not influence prognosis negatively and remains important in gynaecologic oncology decision practice.EUDRACT NR: 2004-000719-25; NCT 00170690.
KW - Journal Article
U2 - 10.1186/s40661-017-0040-2
DO - 10.1186/s40661-017-0040-2
M3 - SCORING: Journal article
C2 - 28286660
VL - 4
SP - 6
ER -
