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晚期高级别卵巢癌的内分泌治疗:来自一项多中心研究的真实数据和文献复习。

Endocrine therapy in advanced high-grade ovarian cancer: real-life data from a multicenter study and a review of the literature.

机构信息

Department of Medical Oncology, CHU Bretonneau Tours, Tours, France.

Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Site René Gauducheau, Saint Herblain, France.

出版信息

Oncologist. 2024 Jul 5;29(7):e910-e917. doi: 10.1093/oncolo/oyae093.

Abstract

BACKGROUND

In women, ovarian cancer is the eighth most frequent cancer in incidence and mortality. It is often diagnosed at advanced stages; relapses are frequent, with a poor prognosis. When platinum resistant, subsequent lines of chemotherapy are of limited effect and often poorly tolerated, leading to quality of life deterioration. Various studies suggest a hormonal role in ovarian carcinogenesis, with a rationale for endocrine therapy in these cancers.

PATIENTS AND METHODS

This multicenter, retrospective study assessed the use of endocrine treatment for high-grade ovarian epithelial carcinomas treated between 2010 and 2020.

RESULTS

Eighty-one patients with ovarian cancers were included. The median duration of platinum sensitivity was 29 months. We observed a 35% disease control rate with endocrine therapy, and 10% reported symptom improvement. For 19 patients (23.5%), the disease was stabilized for more than 6 months. Median overall survival from diagnosis was 62.6 months. Regarding endocrine therapy predictive factors of response, in a multivariate analysis, 3 factors were statistically significant in favoring progression-free survival: platinum sensitivity (P = .021), an R0 surgical resection (P = .020), and the indication for hormone therapy being maintenance therapy (P = .002).

CONCLUSION

This study shows real-life data on endocrine therapy in ovarian cancer. As it is a low-cost treatment with many advantages such as its oral administration and its safety, it may be an option to consider. A perspective lies in the search for cofactors to aim as future therapeutic targets to improve the effectiveness of hormone treatment by means of combination therapy.

摘要

背景

在女性中,卵巢癌是发病率和死亡率第八高的癌症。它通常在晚期诊断;复发频繁,预后不良。当对铂类耐药时,后续的化疗方案效果有限,且往往耐受性差,导致生活质量恶化。各种研究表明激素在卵巢癌发生中起作用,因此这些癌症可以进行内分泌治疗。

患者和方法

这项多中心回顾性研究评估了 2010 年至 2020 年期间治疗高级别卵巢上皮癌时使用内分泌治疗的情况。

结果

共纳入 81 例卵巢癌患者。铂类敏感的中位持续时间为 29 个月。我们观察到内分泌治疗的疾病控制率为 35%,10%的患者报告症状改善。19 名患者(23.5%)疾病稳定超过 6 个月。从诊断到总生存的中位时间为 62.6 个月。关于内分泌治疗的反应预测因素,多因素分析显示 3 个因素有利于无进展生存期:铂类敏感(P=0.021)、R0 手术切除(P=0.020)和激素治疗的适应证为维持治疗(P=0.002)。

结论

本研究展示了卵巢癌内分泌治疗的真实数据。由于它是一种低成本的治疗方法,具有许多优点,如口服和安全性,因此可能是一种值得考虑的选择。未来的治疗目标是寻找协同因子,通过联合治疗提高激素治疗的有效性,这是一个研究方向。

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