Introduction/Background*Recent and detailed data regarding treatment quality and outcome of patients with high grade AOC on a nationwide basis are largely unknown in Germany.
Methodology All German hospitals treating patients with ovarian cancer were asked to document all patients with first diagnosis in the third quarter in 2012 and 2016. Details of tumor, treatment and outcome were documented. This analysis is focusing on patients with AOC FIGO III/IV and the endpoint PFS (progression free survival) (OS data immature for 2016 cohort). As response rates were not documented, we defined a subcohort of patients without progressive disease within 3 months after end of chemotherapy as potential candidates for an additional maintenance therapy.
Result(s)*In total, 1010 patients with high grade AOC with a median age of 65 years were documented. 774/1010 (76.6%) were diagnosed with FIGO III disease and 947/1010 (93.8%) had high-grade serous histologic subtype. 915/1010 (90.6%) had primary cytoreductive surgery. Complete resection was achieved in 434/1010 (43.0%) at primary surgery and in 54/1010 (5.3%) at interval debulking surgery. Carboplatin/paclitaxel/bevacizumab (TCB) was the primary systemic therapy in 627/1010 (62.1%) and carboplatin/paclitaxel (TC) in 292/1010 (28.9%). Median PFS in patients with primary surgery and complete resection was 29.7 months (95% CI 27.4-34.2) compared to 17.2 months (95% CI 15.7-18.9) in all other patients (p<0.001: HR 0.49, 95% CI 0.42-0.57). Median PFS in patients with TCB was 23.3 months (95% CI 22.0-25.3) and 18.5 months (95% CI 15.7-21.9) in patients treated with TC (p=0,083: HR 0.87, 95% CI 0.74-1.02). In total, 899/1010 (89%) did not progress within 3 months.
Conclusion*Most patients in Germany with high grade AOC are treated with primary surgery followed by carboplatin/paclitaxel/bevacizumab. Depending on biomarker status most patients are potential candidates for a PARP-inhibitor maintenance therapy.
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