Are there candidates for high-dose chemotherapy in ovarian carcinoma?
1 Department of Medical Oncology, Institut Paoli-Calmettes, 232 Bd Ste-Marguerite, Marseille 13273, France
2 Department of Molecular Oncology, Centre de Recherche en Cancérologie de Marseille, UMR1068 INSERM, Marseille, France
3 Department of Molecular Pharmacology, Centre de Recherche en Cancérologie de Marseille, UMR1068 INSERM, Marseille, France
4 UFR Medicine, University of Mediterranean, Marseille, France
5 Department of Surgical Oncology, Institut Paoli-Calmettes, Marseille, France
6 Department of Hematology, Institut Paoli-Calmettes, Marseille, France
Journal of Experimental & Clinical Cancer Research 2012, 31:87 doi:10.1186/1756-9966-31-87Published: 16 October 2012
Prognosis of advanced ovarian carcinomas (AOC) remains poor with a 5-year survival of 30%. Benefit from high-dose chemotherapy (HDC) in this disease has not been demonstrated to date.
To evaluate the value of HDC as consolidation treatment after surgery and platinum/taxane-based therapy, we designed a monocentric retrospective comparative study. We used a subset approach to identify parameters associated with HDC efficacy.
One hundred and three AOC patients treated with conventional chemotherapy alone (CCA) were compared to 60 patients receiving HDC plus hematopoietic stem cell support. After a median follow-up of 47.5 months there was no overall survival (OS) advantage for the HDC group in the whole population (p=0.29). Nevertheless, HDC was associated to a better outcome in young patients (≤50 years), both in term of progression-free survival (p=0.02, log-rank test) and OS (p=0.05, log-rank test). Median OS was 54.6 and 36 months in the HDC and CCA groups, respectively.
Although randomized trials failed to demonstrate any benefit for HDC in AOC patients, this study suggests that young patients may derive a substantial advantage from receiving it after the standard treatment. Further prospective studies are warranted to confirm this gain and to search for the biological processes associated with this improvement.