University of Arizona-Phoenix, Department of Obstetrics and Gynecology, Phoenix, AZ, United States of America.
Ontada, The Woodlands, TX, United States of America.
Gynecol Oncol. 2022 Sep;166(3):567-575. doi: 10.1016/j.ygyno.2022.07.026. Epub 2022 Jul 30.
Understanding real-world treatment patterns and proportions of eligible patients in each line of treatment is imperative to inform future clinical trial designs and multi-line treatment algorithm development.
We conducted a retrospective observational cohort study of adult women who received first-line (1 L) therapy for r/mCC between 01 September 2014 and 31 December 2019, using The US Oncology Network electronic health records and chart review data. Patients were followed to 31 December 2020. Patient demographic and clinical characteristics, treatment patterns, and clinical outcomes were assessed descriptively.
A total of 262 patients with r/mCC met study inclusion criteria (mean age = 53 years). The majority of patients in 1 L received platinum-based chemotherapy doublet plus bevacizumab (66%) or chemotherapy doublet alone (24%). Nearly half the patients (48%) completing 1 L received 2 L therapy. Among these patients, there was no consistent 2 L treatment of choice. Overall median time to treatment discontinuation was 3.5 months from 1 L treatment initiation, and median overall treatment-free interval was 2.1 months from 1 L discontinuation. Besides elevated serum creatinine, abnormal BMI indicated a directional trend for lower likelihood of receiving 2 L. Other predictors may include no prior bevacizumab, worse ECOG, and earlier disease prevention.
50% of the patients who initiated 1 L treatment did not receive 2 L therapy, highlighting the need for novel and effective treatment options. As the treatment landscape continues to evolve, we anticipate that more patients will live longer with more treatment options across multiple lines of therapies in the r/mCC setting.
了解每一线治疗中实际治疗模式和合格患者的比例对于为未来临床试验设计和多线治疗算法开发提供信息至关重要。
我们对 2014 年 9 月 1 日至 2019 年 12 月 31 日期间在美国肿瘤学网络电子健康记录和图表审查数据中接受一线（1L）治疗的转移性或复发性卵巢癌成年女性进行了回顾性观察性队列研究。患者随访至 2020 年 12 月 31 日。评估患者的人口统计学和临床特征、治疗模式和临床结局。
共有 262 名 r/mCC 患者符合研究纳入标准（平均年龄=53 岁）。1L 接受含铂化疗双联加贝伐珠单抗（66%）或化疗双联（24%）的患者居多。近一半（48%）完成 1L 治疗的患者接受 2L 治疗。在这些患者中，没有一致的 2L 首选治疗方法。从 1L 治疗开始到治疗终止的总中位时间为 3.5 个月，从 1L 终止到无治疗间隔的总中位时间为 2.1 个月。除了血清肌酐升高外，异常 BMI 表明接受 2L 治疗的可能性较低，这是一种趋势。其他预测因素可能包括既往未使用贝伐珠单抗、ECOG 更差和疾病更早预防。
超过 50%接受 1L 治疗的患者未接受 2L 治疗，这突出表明需要新的有效治疗选择。随着治疗领域的不断发展，我们预计在 r/mCC 环境中，更多的患者将有更多的治疗选择，并在多条治疗线上存活更长时间。
