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2022-RA-1551-ESGO Impact of age on first line treatments of ovarian cancer and their outcomes: results from the Unicancer ESME OVR real-world database
  1. Leïla Bengrine Lefevre1,
  2. Anaïs Fouquier2,
  3. Isabelle Ray-Coquard3,
  4. Laure Favier1,
  5. Florence Joly4,
  6. Manuel Rodrigues5,
  7. Baptiste Sauterey6,
  8. Pierre Emmanuel Colombo7,
  9. Anne Floquet8,
  10. Eric Leblanc9,
  11. Rene Sabatier10,
  12. Emmanuel Barranger11,
  13. Aude-Marie Savoye12,
  14. Patricia Pautier13,
  15. Thierry Petit14,
  16. Jean-Marc Classe15,
  17. Christophe Pomel16,
  18. Aurelie Bertaut17,
  19. Loîc Mourey18,
  20. Lise Bosquet19 and
  21. Claire Falandry20
  1. 1Medical oncology, Centre GEORGES FRANCOIS LECLERC, Dijon, France
  2. 2Biostatistics, Centre GEORGES FRANCOIS LECLERC, DIJON, France
  4. 4medical oncology, Centre François Baclesse, Caen, France
  5. 5Medical oncology, Institut Curie, Paris, France
  6. 6medical oncology, Institut de cancerologie de l’Ouest Centre Paul Papin, Angers, France
  7. 7Deprtment of Surgery, Institut du Cancer de Montpellier, Montpellier, France
  8. 8Medical oncology, Institut Bergonie, Bordeaux, France
  9. 9Department of Surgery, Centre Oscar Lambret, Lille, France
  10. 10medical oncology, Institut Paoli Calmette, Marseille, France
  11. 11Department of Surgery, Centre Antoine Lacassagne, Nice, France
  12. 12Medical oncology, Centre Jean Godinot, Reims, France
  13. 13Medical oncology, Institut Gustave Roussy, Paris, France
  14. 14Medical oncology, Institut de cancérologie de Strasbourg, Strasbourg, France
  15. 15Department of Surgical Oncology, Institut de cancérologie de l’Ouest Centre René Gauducheau, Saint herblain, France
  16. 16Department of Surgical Oncology, Centre Jean Perrin, Clermont-Ferrand, France
  17. 17Health data and Partnership Department, Centre Georges François Leclerc, Dijon, France
  18. 18Department of medical oncology, Institut Claudius Regaud, Toulouse, France
  19. 19Health data and Partnership Department, Unicancer, Paris, France
  20. 20Department of Ageing Medecine, Hospices Civils de Lyon, Lyon, France


Introduction/Background Older patients with advanced ovarian cancer (AOC) have a poor survival. EWOC-1 study showed that carboplatin AUC5 monotherapy (C) was associated with 2.79-fold worse survival compared to carboplatin-paclitaxel (CP) combination in frail older patients. MITO7 study provided exploratory data in favor of weekly CP (wCP) compared to standard CP (sCP) in patients aged ≥70 years. A post hoc study on ICON7 database argued for a higher benefit of bevacizumab (Bev) in chemo-resistant tumors. Confirming the data in a real life database is fundamental to confirm results observed in randomized trials when exploration questioned the frailty.

Methodology On the Unicancer ESME-OVR national database (NCT03275298) were analyzed in patients in first line FIGO stages III-IV high grade AOC the impact of age, chemotherapy regimens and Bev exposure on overall survival.

Results 4686 patients were included, 888 had bevacizumab (≥70: 253); 2583 had sCP (≥70: 570); 171 had C (≥70: 150); 379 had weekly CP (≥70: 132). Median follow-up was 64.9 months, median OS 61.3 months (95%CI: 58.0–63.8). In patients aged ≥70, OS was 43.8 months (95%CI: 40.5–47.0), HR[≥70]: 1.74 (95%CI: 1.59–1.90), p<.001); C was associated with a worse outcome (reference: sCP): HR[C,≥70]: 1.61 (95%CI: 1.29–2.00); HR[wCP,≥70]: 0.96 (95%CI: 0.73–1.27), p≤.001. In patients treated with sCP or wCP, the impact of older age persisted at a lesser extent: HR[≥70,sCP/wCP]: 1.64 (95%CI: 1.46–1.84), p<.0001. Bev tended to improve survival in older patients (HR[Bev,≥70]: 0.80 (95%CI: 0.64–1.01), p=0.057), but not in younger patients (HR[Bev,<70]: 0.96 (95%CI: 0.84–1.10), p=0.596).

Conclusion In this real-world population, C was associated in univariate to a higher risk of death, confirming the conclusions of EWOC-1 trial. When considering sCP/wCP treatment, worse age impact persisted with a 1.64-fold risk of premature death. Bev tended to improve survival raising the possible role of chemo-resistance in the poorer outcome of older patients.

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