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Abstract
Introduction/Background Low grade serous ovarian cancer (LGSOC) is a complex disease, with reported very low response rate to standard cytotoxic agents. Despite a large retrospective study suggested a remarkable efficacy of hormone-therapy as maintenance after platinum-based chemotherapy (CT), due to its rarity very little is known about the best option treatment in the first line setting.
Methodology This is a retrospective case-control study including patients diagnosed with FIGO stage III-IV LGSOC between 2008 and 2021, aiming to assess differences in terms of efficacy between patients treated with CT alone (CT; Group 1), patients treated with CT in combination with Bevacizumab (CT+Bev; Group 2) and women receiving CT followed by hormone-therapy as maintenance (CT+HT; Group 3). Clinical data were collected, and survival analysis was performed for each study group.
Results Out of 84 patients identified, 39 (46.4%) were treated with platinum-based CT alone, 29 (34.5%) received platinum-based CT in combination with Bev and 16 (19.1%) patients received maintenance hormone-therapy after platinum-based CT. Median ages at the time of diagnosis were 49 years (range, 21–82), 47.7 years (range, 21–70) and 38 years (range, 18–60), for Group 1, 2 and 3, respectively. No statistically significant differences in FIGO stage, rate of primary or interval debulking cytoreduction, and residual tumor (gross vs absent) at upfront surgery were identified among the groups (table 1).Median PFS was 39 months in Group 1, 39 months in Group 2 and not reached in the group of patients receiving hormone-therapy as maintenance (Group 3) (log rank p=0.07), with a statistically significant advantage of Group 3 over Group 1 (p=0.021) (figure 1). Median OS was not reached in all Groups (p=0.18).
Conclusion Although the small simple size, these data suggest that maintenance with hormone therapy after platinum-based CT could represent the best therapeutic choice in this disease.