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Impact of Chemotherapy Beyond the Third Line in Patients With Recurrent Epithelial Ovarian Cancer
  1. Laura Mansi, MD*,,,
  2. Martin Demarchi,
  3. Fernando Bazan,
  4. Delphine Delroeux*,
  5. Loïc Chaigneau,
  6. Antoine Thiery-Vuillemin*,,,
  7. Sandrine Bernhard,
  8. Zaehr Lakkis§,
  9. Virginie Nerich,
  10. Xavier Pivot*,, and
  11. Elsa Kalbacher
  1. *EA4267-UFR-33, School of Medecine and Pharmacy;
  2. Medical Oncology Unit, J. Minjoz University Teaching Hospital;
  3. INSERM U 645, EA-2284 IFR-133; and
  4. §Department of Surgery and
  5. Pharmacy Department, J. Minjoz University Hospital, Besançon, France.
  1. Address correspondence and reprint requests to Laura Mansi Laura, MD, CHU Jean Minjoz Besançon Blvd, Flemming 25000, Besançon, France. E-mail:


Objectives The goal of this study was to determine the benefit in terms of time disease control (TDC) achieved by the succession of chemotherapy beyond the third line in patients treated for recurrent epithelial ovarian cancer. Secondary objectives were to identify patients who benefited from treatments beyond 3 lines and to estimate overall survival and disease-free progression lengths.

Materials and Methods The cohort of 122 patients was identified from a pharmacy database of patients treated with chemotherapy between 1992 and 2010. The evaluation of benefit obtained by each line was based on TDC duration, defined as the interval between the beginning of the treatment and the date of progressive disease or death.

Results Median TDC durations was 4.15 (0–54.7), 4 (0–21.7), 3.34 (0–29.6), 4.97 (0–29.2), and 3.13 months (0–15) for the fourth to eighth lines, respectively. Time to disease control was longer than 6 months in 34% to 40% of patients treated by lines 4 to 8. The most important factor influencing TDC length beyond the third line was the TDC duration observed in the 2 previous lines of therapy. Median overall survival after the third line was 15.3 months (95% confidence interval, 12–20 months). Factors associated with longer overall survival after 3 lines were performance status lower than 2 (P = 0.0058), no hepatic metastasis (P = 0.0098), no pulmonary metastasis (P = 0.0003), and platinum sensitivity (P = 0.04)

Conclusions These results may justify the administration of chemotherapy beyond the third line, in particular when the 2 previous lines are effective and resulted in disease control longer than 6 months.

  • Ovarian epithelial cancer
  • Recurrent
  • Benefit
  • Time disease control
  • Chemotherapy

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  • The authors declare no conflicts of interest.