Chemotherapy Toxicity and Survival in Ovarian Cancer
Author Information
Author(s): Lee C K, Gurney H, Brown C, Sorio R, Donadello N, Tulunay G, Meier W, Bacon M, Maenpaa J, Petru E, Reed N, Gebski V, Pujade-Lauraine E, Lord S, Simes R J, Friedlander M
Primary Institution: NHMRC Clinical Trials Centre, University of Sydney
Hypothesis
In patients with platinum-sensitive ovarian cancer treated with carboplatin–paclitaxel, leukopenia and sensory neuropathy would be associated with superior progression-free survival.
Conclusion
First-cycle leukopenia and neuropathy were prognostic for patients treated with carboplatin–paclitaxel, indicating that these toxicities may reflect better treatment outcomes.
Supporting Evidence
- 72% of patients treated with carboplatin–paclitaxel experienced leukopenia.
- Leukopenia was associated with a 34% reduction in the risk of disease progression.
- Neuropathy was reported in 32% of patients, with a significant difference in PFS in the CP group.
- Carboplatin–liposomal doxorubicin was more effective than carboplatin–paclitaxel in patients without leukopenia.
Takeaway
If patients getting chemotherapy for ovarian cancer get sick from the treatment, it might mean the treatment is working better for them.
Methodology
A landmark analysis was performed to correlate leukopenia and neuropathy during the first cycle of chemotherapy with progression-free survival using time-dependent proportional-hazards models.
Potential Biases
Patients without nadir blood count were different in terms of some baseline characteristics and other toxicities experienced during cycle 1.
Limitations
Approximately one third of the randomised patients did not have nadir blood count recorded during the first cycle of chemotherapy and were excluded from analysis.
Participant Demographics
Median age was 59.4 years, with a mix of treatment arms and ECOG performance statuses.
Statistical Information
P-Value
0.01
Confidence Interval
0.61–0.94
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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