e16509 Background: First line dose-dense (dd) regimens improve PFS in patients (pts) with advanced ovarian cancer, but also increase hematological toxicity, peripheral neuropathy and usage of G-CSF. Nowadays it is unknown which pts benefit from this treatment. Methods: The analysis included 156 pts with ovarian carcinoma stages Ic-IV, who received paclitaxel (Ptx) and platinum agents in first line chemotherapy (CT) from 1996 to 2010 in our center. Retrospective group contained 91 pts, who were administered standard regimens (Ptx 175 mg/m2 + Carboplatin (C) AUC5-6 /Cisplatin (DDP) 75 mg/m2 every 3 weeks). Prospective group included 65 pts. Forty of them received 9 cycles Ptx 150 mg/m2+DDP 50 mg/m2 every 2 weeks, 25 pts were given 6 cycles Ptx 80 mg/m21,8,15 days + C AUC6 every 3 weeks. Results: Median PFS in the dd (12.5 months) and the standard arms (13.3 months) were not statistically significantly different (p = 0.6, HR 0.9; 95% CI 0.61-1.37). Multivariate analysis revealed the optimality (p=0.006) and time (p = 0.008) of cytoreduction were found as the strongest factors exerted on PFS and could take effect on choice of CT regimen. Median PFS was longer in pts with primary optimal cytoreduction (26.3 months) than in group with primary non optimal, interval debulking or without any surgery treatment (10.9 months) (p < 0.0001, HR 0.28; 95% CI 0.23-0.55). The dd regimens prolonged PFS in comparison with the standard arm in pts with favorable prognosis (primary optimal cytoreduction): median was not reached vs 15.1 months respectively (p = 0.02, HR 0.36; 95%CI 0.13-1.2). Meanwhile, median PFS in unfavorable prognostic group was not different between 2 arms: 10.3 vs 11.5 months respectively (p = 0.4 HR 1.26; 95% CI 0.8-2.02). Conclusions: First-line dd statistically significantly prolong PFS in pts with primary optimal cytoreduction comparing with standard conventional CT. It is necessary to validate this predictive factor in prospective trial.
Development of a geriatric vulnerability score in elderly patients with advanced ovarian cancer treated with first-line carboplatin: a GINECO prospective trial