more new research: Early Versus Delayed Treatment of Relapsed Ovarian Cancer

lindaprocopio

Early Versus Delayed Treatment of Relapsed Ovarian Cancer (MRC OV05/EORTC 55955): A Randomised Trial

Lancet. 2010 Oct 1;376(9747):1155-1163, GJS Rustin, MEL van der Burg, CL Griffin, D Guthrie, A Lamont, C Jayson, G Kristensen, C Mediola, C Coens, W Qian, MKB Parmar, AM Swart for the MRC OV05, EORTC 55955 Investigators

ABSTRACT
Background: Serum CA125 concentration often rises several months before clinical or symptomatic relapse in women with ovarian cancer. In the MRC OV05/EORTC 55955 collaborative trial, we aimed to establish the benefits of early treatment on the basis of increased CA125 concentrations compared with delayed treatment on the basis of clinical recurrence.
Methods: Women with ovarian cancer in complete remission after first-line platinum-based chemotherapy and a normal CA125 concentration were registered for this randomised controlled trial. Clinical examination and CA125 measurement were done every 3 months. Patients and investigators were masked to CA125 results, which were monitored by coordinating centres. If CA125 concentration exceeded twice the upper limit of normal, patients were randomly assigned (1:1) by minimisation to early or delayed chemotherapy. Patients and clinical sites were informed of allocation to early treatment, and treatment was started as soon as possible within 28 days of the increased CA125 measurement. Patients assigned to delayed treatment continued masked CA125 measurements, with treatment commencing at clinical or symptomatic relapse. All patients were treated according to standard local practice. The primary outcome was overall survival. Analysis was by intention to treat. This study is registered, ISRCTN87786644.

Findings: 1442 patients were registered for the trial, of whom 529 were randomly assigned to treatment groups and were included in our analysis (265 early, 264 delayed). With a median follow-up of 56.9 months (IQR 37.4—81.8) from randomisation and 370 deaths (186 early, 184 delayed), there was no evidence of a difference in overall survival between early and delayed treatment (HR 0.98, 95% CI 0.80—1.20, p=0.85). Median survival from randomisation was 25.7 months (95% CI 23.0—27.9) for patients on early treatment and 27.1 months (22.8—30.9) for those on delayed treatment.

Interpretation: Our findings showed no evidence of a survival benefit with early treatment of relapse on the basis of a raised CA125 concentration alone, and therefore the value of routine measurement of CA125 in the follow-up of patients with ovarian cancer who attain a complete response after first-line treatment is not proven.

froggy1

Wow
This sure does make our decisions as clear as mud. I think my Doc must have read that one, based on our conversation yesterday. It must be so frustrating for them.

Thanks for posting, Ginny

kikiz

froggy1 said:

Wow
This sure does make our decisions as clear as mud. I think my Doc must have read that one, based on our conversation yesterday. It must be so frustrating for them.

Thanks for posting, Ginny

Do I understand this?
I just read this. I may not be the brightest bulb around but this sounds almost like amunition to get rid of our CA 125 test like they just did with the change of age for Mammograms. I want both tests and I want to be consulted as to what I think is best for ME. I can imagine being in remission and only getting a CT Scan every 6 months. No other test. I can also picture the insurance company saying that until the scan shows it, NO CHEMO. Maybe I am reading to much into this study and someone help me understand it differently because I am with Ginny on this, Clear as MUD

Thanks,
Lori

Cafewoman53

kikiz said:

Do I understand this?
I just read this. I may not be the brightest bulb around but this sounds almost like amunition to get rid of our CA 125 test like they just did with the change of age for Mammograms. I want both tests and I want to be consulted as to what I think is best for ME. I can imagine being in remission and only getting a CT Scan every 6 months. No other test. I can also picture the insurance company saying that until the scan shows it, NO CHEMO. Maybe I am reading to much into this study and someone help me understand it differently because I am with Ginny on this, Clear as MUD

Thanks,
Lori

You are smart !
Isn't it funny how quick they are to get rid of tests for us women yet continue without comment the psa tests for men and they have the same problems with that test false negatives and false positives.

leesag

Cafewoman53 said:

You are smart !
Isn't it funny how quick they are to get rid of tests for us women yet continue without comment the psa tests for men and they have the same problems with that test false negatives and false positives.

bump

bump

Tina Brown

Well that puts my theory in
Well that puts my theory in the dustbin. I thought that by catching it early was a bonus. Oh well sometimes we have to accept what we have and just take all the treatment we can handle and hope its gonna work.

Tina

msfanciful

I think that says it
I think that says it all!

Just great!