Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado.
Department of Medical Oncology, University of Colorado School of Medicine, Aurora, Colorado.
Cancer. 2020 Oct 1;126(19):4289-4293. doi: 10.1002/cncr.33073. Epub 2020 Jul 22.
Patients with ovarian cancer who are enrolled on phase 1 trials typically have platinum-resistant and heavily pretreated disease, with a poor prognosis. In the current study, the authors assessed prognostic factors and survival in women with recurrent ovarian cancer who were treated on phase 1 clinical trials.
The authors performed a retrospective analysis of patients treated from 2008 through 2018 at the University of Colorado Cancer Center. Patient characteristics and treatment and toxicity-related survival data were assessed. Descriptive statistics and Cox proportional hazards models were used to identify risk factors associated with survival time.
A total of 132 patients were treated on phase 1 clinical trials. Patients had a median age of 59 years (range, 33-88 years) with a median of 5.5 previous chemotherapy lines (range, 1-13 lines). Of the 132 patients, 53 (40%) were treated on multiple phase 1 trials with a median of 1 (range, 0-5) prior phase 1 trial. The overall response rate was 14.7%. The median overall survival was 11.3 months (95% CI, 9.1-13.4 months). Two patients died on trial due to progression of disease whereas no patients died of treatment-related toxicity. Independent risk factors found to be predictive of shorter survival were an elevated cancer antigen 125 (CA 125) level (hazard ratio [HR], 2.8; 95% CI, 1.6-5.2) and albumin <3.5 g/dL (HR, 2.5; 95% CI, 1.65-3.79). A body mass index >25 kg/m was predictive of longer survival (HR, 0.65; 95% CI, 0.44-0.96).
In the current single-institution series, patients with heavily pretreated ovarian cancer who were treated on phase 1 clinical trials experienced a median overall survival of 11.3 months. When available, phase 1 clinical trials represent a reasonable treatment option for patients with heavily pretreated ovarian cancer with a preserved performance status.
入组 1 期临床试验的卵巢癌患者通常患有铂类耐药和大量预处理的疾病,预后较差。在本研究中,作者评估了在 1 期临床试验中接受治疗的复发性卵巢癌女性的预后因素和生存情况。
作者对 2008 年至 2018 年在科罗拉多大学癌症中心接受治疗的患者进行了回顾性分析。评估了患者特征、治疗和与毒性相关的生存数据。使用描述性统计和 Cox 比例风险模型来确定与生存时间相关的风险因素。
共有 132 名患者接受了 1 期临床试验治疗。患者的中位年龄为 59 岁(范围,33-88 岁),中位化疗线数为 5.5 条(范围,1-13 条)。在 132 名患者中,有 53 名(40%)接受了多次 1 期临床试验治疗,其中中位数为 1 次(范围,0-5 次)之前的 1 期试验。总的缓解率为 14.7%。中位总生存期为 11.3 个月(95%CI,9.1-13.4 个月)。有 2 名患者因疾病进展而在试验中死亡,而没有患者因治疗相关毒性而死亡。独立的风险因素发现,较短的生存预测因素包括癌抗原 125(CA 125)水平升高(风险比[HR],2.8;95%CI,1.6-5.2)和白蛋白<3.5g/dL(HR,2.5;95%CI,1.65-3.79)。体重指数(BMI)>25kg/m 预测生存时间更长(HR,0.65;95%CI,0.44-0.96)。
在本单机构系列中,接受 1 期临床试验治疗的大量预处理卵巢癌患者的中位总生存期为 11.3 个月。在可行的情况下,1 期临床试验代表了一种合理的治疗选择,适用于具有保留的体能状态的大量预处理卵巢癌患者。