Hormonal Maintenance Therapy Improves Survival in Rare Ovarian, Peritoneum Cancer

Hormone maintenance therapy (HMT) may increase survival in patients with low-grade serous carcinoma (LGSC) of the ovary or peritoneum.

LGSC is a rare, slow-growing cancer that is generally resistant to cytotoxic chemotherapy. It is typically diagnosed in women as early as their 40s and 50s, and is usually caught in its advanced stages.

“There is a true unmet need for these patients—–roughly 70% of women with this disease will experience a recurrence of the cancer at some point,” said David M. Gershenson, MD, investigator of the study published in the Journal of Clinical Oncology. “Our group published research demonstrating that hormonal therapy showed promise in the recurrent setting, with most patients responding or having stable disease. It was a natural progression over time that we began to study this up front, after women received their primary chemotherapy.”

For the retrospective cohort study, the investigators analyzed data from 203 women with stage 2 to 4 LGSC who were treated at MD Anderson between 1981 and 2013, to evaluate the effect of HMT compared with surveillance, following surgery and chemotherapy. Of the 203 women, 70 received HMT and 133 were placed in the surveillance arm.

The results of the study showed an average progression-free survival (PFS) of 64.9 months for women in the HMT arm compared with 26.4 months in the surveillance arm. The overall survival (OS) was 115.7 months following HMT compared with 102.7 months for the surveillance group.

Among 149 participants who showed no evidence of disease following completion of primary chemotherapy, HMT had even greater survival of 81.1 versus 30 months PFS, and 191.3 versus 106.8 months OS.

“Hormonal therapy has shown promising results in reducing cancer recurrence, and there is increasing interest in integrating this approach into first-line therapy,” Gershenson said. “If confirmatory research in a clinical trial setting shows hormonal maintenance therapy can prevent or delay recurrence of this cancer subtype, it would be practice changing.”

According to the authors, a prospective international phase 3 clinical trial has been designed to compare the efficacy of chemotherapy and observation; chemotherapy and HMT; and HMT alone.