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OP022/#597 Optimizing the number of cycles of neoadjuvant chemotherapy in advanced epithelial ovarian carcinoma: a propensity-score matching analysis
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  1. A Rosati1,
  2. C Marchetti1,
  3. F De Felice2,
  4. S Boccia1,
  5. L Vertechy1,
  6. M Pavone1,
  7. E Palluzzi1,
  8. G Scambia1 and
  9. A Fagotti1
  1. 1Università Cattolica del Sacro Cuore, Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli Irccs, Roma, Italy
  2. 2Policlinico Umberto I, ‘Sapienza’ University of Rome, Department of Radiotherapy, Rome, Italy

Abstract

Objectives Neoadjuvant chemotherapy and interval debulking surgery are widely offered in advanced ovarian cancer patients; the number of NACT cycles to be given is still an issue. Our aim was to compare survival outcomes of patients with advanced ovarian cancer treated with <4 or more NACT cycles.

Methods A cohort of patients with stage III-IV epithelial OC undergoing NACT followed by IDS was identified. Patients were classified in group A (≤4 cycles) and group B (>4 cycles). Selection bias was avoided using propensity score matching (2:1 ratio).

Results 140 (group A) and 70 (group B) patients were included. After the propensity score matching, there were no imbalances in baseline characteristics. BRCA status was associated to improved OS (HR=0.41; 95%CI 0.18.0.92, p=0.032) and residual tumor to decreased OS (HR=1.93; 95%CI 1.08–3.46, p=0.026). Statistically significant differences were not observed in OS (2-year OS 82.4% for group A versus 77.1% for group B, p=0.109) and PFS (2-year PFS 29.7% for group A versus 20.0% for group A, p=0.875) (figure 1). In group B, the administration of >4 cycles was related to an additional chance of achieving complete (12.9%) and partial (34.3%) responses compared to responses after 3–4 cycles (figure 2).

Abstract OP022/#597 Figure 1

Overall survival and disease free survival in group A and group B

Abstract OP022/#597 Figure 2

Treatment response between groups. Group A (3–4 cycles); Group B (at least 6 cycles); B1 response assessment after 3–4 cycles; B2 response assessment after at least 6 cycles

Conclusions Receiving more than 4 cycles of NACT is no detrimental in terms of OS and PFS in advanced ovarian cancer. Response rates can increase following further cycles administration.

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