Platinum versus platinum-combination chemotherapy in platinum-sensitive recurrent ovarian cancer: a meta-analysis using individual patient data
The majority of women with ovarian cancer develop recurrent disease. For patients with a platinum-free interval of >6 months, platinum-based chemotherapy is a treatment of choice. The benefit of platinum-based combination chemotherapy in randomized trials varies, and a meta-analysis was carried o...
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| Veröffentlicht in: | Annals of oncology 2013-12, Vol.24 (12), p.3028-3034 |
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| creator | Raja, F.A. Counsell, N. Colombo, N. Pfisterer, J. du Bois, A. Parmar, M.K. Vergote, I.B. Gonzalez-Martin, A. Alberts, D.S. Plante, M. Torri, V. Ledermann, J.A. |
| description | The majority of women with ovarian cancer develop recurrent disease. For patients with a platinum-free interval of >6 months, platinum-based chemotherapy is a treatment of choice. The benefit of platinum-based combination chemotherapy in randomized trials varies, and a meta-analysis was carried out to gain more secure information on the size of the benefit of this treatment.
We initiated a systematic review and meta-analysis following a pre-specified protocol to determine whether combination chemotherapy is superior to single-agent platinum chemotherapy in women with relapsed platinum-sensitive ovarian cancer.
A total of five potentially eligible randomized trials were identified that had used combination-platinum chemotherapy versus single-agent platinum chemotherapy in women with relapsed platinum-sensitive ovarian cancer. For one trial (190 patients), adequate contact with the investigators could not be established. Therefore, four trials that randomly assigned 1300 patients were included, with a median follow-up of 36.1 months. Overall survival (OS) analyses were based on 865 deaths and demonstrated evidence for the benefit of combination-platinum chemotherapy (HR = 0.80; 95% CI, 0.64–1.00; P = 0.05). Progression-free survival (PFS) analyses were based on 1167 events and demonstrated strong evidence for the benefit of combination-platinum chemotherapy (HR = 0.68; 95% CI, 0.57–0.81; P < 0.001). There was no evidence of a difference in the relative effect of combination-platinum chemotherapy on either OS or PFS in patient subgroups defined by previous paclitaxel (Taxol) treatment (OS, P = 0.49; PFS, P = 0.66), duration of treatment-free interval (OS, P = 0.86; PFS, P = 0.48) or the number of previous lines of chemotherapy (OS, P = 0.21; PFS, P = 0.27).
In this individual patient data (IPD) meta-analysis, we have demonstrated that combination-platinum chemotherapy improves OS and PFS across all subgroups. This provides the strongest evidence to date of the benefit of combination-platinum over single-agent platinum. |
| doi_str_mv | 10.1093/annonc/mdt406 |
| format | Article |
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We initiated a systematic review and meta-analysis following a pre-specified protocol to determine whether combination chemotherapy is superior to single-agent platinum chemotherapy in women with relapsed platinum-sensitive ovarian cancer.
A total of five potentially eligible randomized trials were identified that had used combination-platinum chemotherapy versus single-agent platinum chemotherapy in women with relapsed platinum-sensitive ovarian cancer. For one trial (190 patients), adequate contact with the investigators could not be established. Therefore, four trials that randomly assigned 1300 patients were included, with a median follow-up of 36.1 months. Overall survival (OS) analyses were based on 865 deaths and demonstrated evidence for the benefit of combination-platinum chemotherapy (HR = 0.80; 95% CI, 0.64–1.00; P = 0.05). Progression-free survival (PFS) analyses were based on 1167 events and demonstrated strong evidence for the benefit of combination-platinum chemotherapy (HR = 0.68; 95% CI, 0.57–0.81; P < 0.001). There was no evidence of a difference in the relative effect of combination-platinum chemotherapy on either OS or PFS in patient subgroups defined by previous paclitaxel (Taxol) treatment (OS, P = 0.49; PFS, P = 0.66), duration of treatment-free interval (OS, P = 0.86; PFS, P = 0.48) or the number of previous lines of chemotherapy (OS, P = 0.21; PFS, P = 0.27).
In this individual patient data (IPD) meta-analysis, we have demonstrated that combination-platinum chemotherapy improves OS and PFS across all subgroups. This provides the strongest evidence to date of the benefit of combination-platinum over single-agent platinum.</description><identifier>ISSN: 0923-7534</identifier><identifier>EISSN: 1569-8041</identifier><identifier>DOI: 10.1093/annonc/mdt406</identifier><identifier>PMID: 24190964</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Antineoplastic agents ; Antineoplastic Combined Chemotherapy Protocols - pharmacology ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; Carboplatin - administration & dosage ; Cisplatin - administration & dosage ; Disease-Free Survival ; Female ; Female genital diseases ; Gynecology. Andrology. Obstetrics ; Humans ; IPD meta-analysis ; Kaplan-Meier Estimate ; Medical sciences ; Multiple tumors. Solid tumors. Tumors in childhood (general aspects) ; Neoplasm Recurrence, Local - drug therapy ; Neoplasm Recurrence, Local - mortality ; Ovarian Neoplasms - drug therapy ; Ovarian Neoplasms - mortality ; Pharmacology. Drug treatments ; Randomized Controlled Trials as Topic ; recurrent ovarian cancer ; Treatment Outcome ; Tumors</subject><ispartof>Annals of oncology, 2013-12, Vol.24 (12), p.3028-3034</ispartof><rights>2013 European Society for Medical Oncology</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-37d42214705d40daa82ab5e660be9b9902802de53cef1e39198fd684811976ed3</citedby><cites>FETCH-LOGICAL-c476t-37d42214705d40daa82ab5e660be9b9902802de53cef1e39198fd684811976ed3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28036420$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24190964$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Raja, F.A.</creatorcontrib><creatorcontrib>Counsell, N.</creatorcontrib><creatorcontrib>Colombo, N.</creatorcontrib><creatorcontrib>Pfisterer, J.</creatorcontrib><creatorcontrib>du Bois, A.</creatorcontrib><creatorcontrib>Parmar, M.K.</creatorcontrib><creatorcontrib>Vergote, I.B.</creatorcontrib><creatorcontrib>Gonzalez-Martin, A.</creatorcontrib><creatorcontrib>Alberts, D.S.</creatorcontrib><creatorcontrib>Plante, M.</creatorcontrib><creatorcontrib>Torri, V.</creatorcontrib><creatorcontrib>Ledermann, J.A.</creatorcontrib><title>Platinum versus platinum-combination chemotherapy in platinum-sensitive recurrent ovarian cancer: a meta-analysis using individual patient data</title><title>Annals of oncology</title><addtitle>Ann Oncol</addtitle><description>The majority of women with ovarian cancer develop recurrent disease. For patients with a platinum-free interval of >6 months, platinum-based chemotherapy is a treatment of choice. The benefit of platinum-based combination chemotherapy in randomized trials varies, and a meta-analysis was carried out to gain more secure information on the size of the benefit of this treatment.
We initiated a systematic review and meta-analysis following a pre-specified protocol to determine whether combination chemotherapy is superior to single-agent platinum chemotherapy in women with relapsed platinum-sensitive ovarian cancer.
A total of five potentially eligible randomized trials were identified that had used combination-platinum chemotherapy versus single-agent platinum chemotherapy in women with relapsed platinum-sensitive ovarian cancer. For one trial (190 patients), adequate contact with the investigators could not be established. Therefore, four trials that randomly assigned 1300 patients were included, with a median follow-up of 36.1 months. Overall survival (OS) analyses were based on 865 deaths and demonstrated evidence for the benefit of combination-platinum chemotherapy (HR = 0.80; 95% CI, 0.64–1.00; P = 0.05). Progression-free survival (PFS) analyses were based on 1167 events and demonstrated strong evidence for the benefit of combination-platinum chemotherapy (HR = 0.68; 95% CI, 0.57–0.81; P < 0.001). There was no evidence of a difference in the relative effect of combination-platinum chemotherapy on either OS or PFS in patient subgroups defined by previous paclitaxel (Taxol) treatment (OS, P = 0.49; PFS, P = 0.66), duration of treatment-free interval (OS, P = 0.86; PFS, P = 0.48) or the number of previous lines of chemotherapy (OS, P = 0.21; PFS, P = 0.27).
In this individual patient data (IPD) meta-analysis, we have demonstrated that combination-platinum chemotherapy improves OS and PFS across all subgroups. This provides the strongest evidence to date of the benefit of combination-platinum over single-agent platinum.</description><subject>Antineoplastic agents</subject><subject>Antineoplastic Combined Chemotherapy Protocols - pharmacology</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Carboplatin - administration & dosage</subject><subject>Cisplatin - administration & dosage</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Female genital diseases</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>IPD meta-analysis</subject><subject>Kaplan-Meier Estimate</subject><subject>Medical sciences</subject><subject>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</subject><subject>Neoplasm Recurrence, Local - drug therapy</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Ovarian Neoplasms - drug therapy</subject><subject>Ovarian Neoplasms - mortality</subject><subject>Pharmacology. Drug treatments</subject><subject>Randomized Controlled Trials as Topic</subject><subject>recurrent ovarian cancer</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0923-7534</issn><issn>1569-8041</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU2L1TAUhoMoznV06VayEdzUOUnTtHEnw_gBA7rQdTlNTp1Im9YkLdxf4V82w706K1eHA895OTwvYy8FvBVg6isMYQn2anZZgX7EDqLRpupAicfsAEbWVdvU6oI9S-knAGgjzVN2IZUwYLQ6sN9fJ8w-bDPfKaYt8fW8V3aZBx_KsgRu72he8h1FXI_chwcoUUg--514JLvFSCHzZcfosRxhsBTfceQzZaww4HRMPvEt-fCjpDi_e7fhxNcSdn_oMONz9mTEKdGL87xk3z_cfLv-VN1--fj5-v1tZVWrc1W3TkkpVAuNU-AQO4lDQ1rDQGYwBmQH0lFTWxoF1UaYbnS6U50QptXk6kv25pS7xuXXRin3s0-WpgkDLVvqhdKybgGkLmh1Qm1cUoo09mv0M8ZjL6C_76A_ddCfOij8q3P0Nszk_tF_pRfg9RnAZHEaYxHl0wPXQa2VhMK1J46KiN1T7JMtoiw5X2zn3i3-Py_8AXlcqQI</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Raja, F.A.</creator><creator>Counsell, N.</creator><creator>Colombo, N.</creator><creator>Pfisterer, J.</creator><creator>du Bois, A.</creator><creator>Parmar, M.K.</creator><creator>Vergote, I.B.</creator><creator>Gonzalez-Martin, A.</creator><creator>Alberts, D.S.</creator><creator>Plante, M.</creator><creator>Torri, V.</creator><creator>Ledermann, J.A.</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20131201</creationdate><title>Platinum versus platinum-combination chemotherapy in platinum-sensitive recurrent ovarian cancer: a meta-analysis using individual patient data</title><author>Raja, F.A. ; Counsell, N. ; Colombo, N. ; Pfisterer, J. ; du Bois, A. ; Parmar, M.K. ; Vergote, I.B. ; Gonzalez-Martin, A. ; Alberts, D.S. ; Plante, M. ; Torri, V. ; Ledermann, J.A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-37d42214705d40daa82ab5e660be9b9902802de53cef1e39198fd684811976ed3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Antineoplastic agents</topic><topic>Antineoplastic Combined Chemotherapy Protocols - pharmacology</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Carboplatin - administration & dosage</topic><topic>Cisplatin - administration & dosage</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Female genital diseases</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>IPD meta-analysis</topic><topic>Kaplan-Meier Estimate</topic><topic>Medical sciences</topic><topic>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</topic><topic>Neoplasm Recurrence, Local - drug therapy</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Ovarian Neoplasms - drug therapy</topic><topic>Ovarian Neoplasms - mortality</topic><topic>Pharmacology. 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For patients with a platinum-free interval of >6 months, platinum-based chemotherapy is a treatment of choice. The benefit of platinum-based combination chemotherapy in randomized trials varies, and a meta-analysis was carried out to gain more secure information on the size of the benefit of this treatment.
We initiated a systematic review and meta-analysis following a pre-specified protocol to determine whether combination chemotherapy is superior to single-agent platinum chemotherapy in women with relapsed platinum-sensitive ovarian cancer.
A total of five potentially eligible randomized trials were identified that had used combination-platinum chemotherapy versus single-agent platinum chemotherapy in women with relapsed platinum-sensitive ovarian cancer. For one trial (190 patients), adequate contact with the investigators could not be established. Therefore, four trials that randomly assigned 1300 patients were included, with a median follow-up of 36.1 months. Overall survival (OS) analyses were based on 865 deaths and demonstrated evidence for the benefit of combination-platinum chemotherapy (HR = 0.80; 95% CI, 0.64–1.00; P = 0.05). Progression-free survival (PFS) analyses were based on 1167 events and demonstrated strong evidence for the benefit of combination-platinum chemotherapy (HR = 0.68; 95% CI, 0.57–0.81; P < 0.001). There was no evidence of a difference in the relative effect of combination-platinum chemotherapy on either OS or PFS in patient subgroups defined by previous paclitaxel (Taxol) treatment (OS, P = 0.49; PFS, P = 0.66), duration of treatment-free interval (OS, P = 0.86; PFS, P = 0.48) or the number of previous lines of chemotherapy (OS, P = 0.21; PFS, P = 0.27).
In this individual patient data (IPD) meta-analysis, we have demonstrated that combination-platinum chemotherapy improves OS and PFS across all subgroups. This provides the strongest evidence to date of the benefit of combination-platinum over single-agent platinum.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>24190964</pmid><doi>10.1093/annonc/mdt406</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Antineoplastic agents Antineoplastic Combined Chemotherapy Protocols - pharmacology Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences Carboplatin - administration & dosage Cisplatin - administration & dosage Disease-Free Survival Female Female genital diseases Gynecology. Andrology. Obstetrics Humans IPD meta-analysis Kaplan-Meier Estimate Medical sciences Multiple tumors. Solid tumors. Tumors in childhood (general aspects) Neoplasm Recurrence, Local - drug therapy Neoplasm Recurrence, Local - mortality Ovarian Neoplasms - drug therapy Ovarian Neoplasms - mortality Pharmacology. Drug treatments Randomized Controlled Trials as Topic recurrent ovarian cancer Treatment Outcome Tumors |
| title | Platinum versus platinum-combination chemotherapy in platinum-sensitive recurrent ovarian cancer: a meta-analysis using individual patient data |
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