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Evaluating the impact of dose reductions and delays on progression-free survival in women with ovarian cancer treated with either three-weekly or dose-dense carboplatin and paclitaxel regimens in the national prospective OPAL cohort study

Title: Evaluating the impact of dose reductions and delays on progression-free survival in women with ovarian cancer treated with either three-weekly or dose-dense carboplatin and paclitaxel regimens in the national prospective OPAL cohort study
Authors: Sivakumaran, T.; Mileshkin, L.; Grant, P.; Na, L.; DeFazio, A.; Friedlander, M.; Obermair, A.; Webb, P. M.; Au-Yeung, G.; OPAL Study Group
Publisher Information: Academic Press
Publication Year: 2020
Collection: The University of Queensland: UQ eSpace
Subject Terms: Adjuvant; Dose delays; Dose reductions; Ovarian cancer; Patient outcomes; 2729 Obstetrics and Gynaecology; 2730 Oncology
Description: Objectives: To determine the impact of chemotherapy dose reductions and dose delays on progression-free survival (PFS) in women with ovarian cancer receiving first line chemotherapy in a real world prospective cohort study. Methods: Patients with newly diagnosed epithelial ovarian (or peritoneal, fallopian tube) cancer enrolled in a national Australian prospective study, OPAL, who commenced three-weekly carboplatin (AUC 5 or 6) and paclitaxel 175 mg/m (CP) or carboplatin (AUC 5 or 6) and dose-dense weekly paclitaxel 80 mg/m (DD-CP) were eligible. Primary endpoint was PFS. Results: 634 evaluable patients, 309 commenced CP and 325 DD-CP. Patient's age was similar in the two groups (median 62 years, range 21–79). All planned chemotherapy doses were completed by 66% vs 40% (p < 0.001) in the CP and DD-CP groups respectively. There was at least one treatment delay in 28% vs 58% (p < 0.001) in the CP and DD-CP groups, respectively, and 29% vs 49% (p < 0.001), respectively, required at least a 15% dose reduction for either carboplatin or paclitaxel. Median PFS was 29.2 [22.9, 43.8] and 21.5 [19.4, 23.1] months in the CP and DD-CP groups respectively. Adjusting for age, histology and FIGO stage PFS did not differ between treatment groups. Median PFS was similar in patients irrespective of dose reduction or dose delay. Conclusion: Patients receiving DD-CP required more dose reductions and delays due to haematological toxicities and lower completion rates than CP without significant difference in median PFS between CP and DD-CP. Median PFS was similar in patients irrespective of dose reduction or dose delay.
Document Type: article in journal/newspaper
Language: English
ISSN: 1095-6859; 0090-8258
Relation: orcid:0000-0003-2199-1117; orcid:0000-0003-0733-5930; APP1025142; APP1120431
Availability: https://espace.library.uq.edu.au/view/UQ:f1ce5a2
Accession Number: edsbas.B7C8B67F
Database: BASE