Developmental chemotherapy in advanced ovarian cancer: Incorporation of newer cytotoxic agents in a phase III randomized trial of the Gynecologic Oncology Group (GOG-0182)

2002 ◽  
Vol 29 (1) ◽  
pp. 20-31 ◽  
Author(s):  
Michael A Bookman
Keyword(s):  
Ovarian Cancer ◽  
Randomized Trial ◽  
Gynecologic Oncology ◽  
Advanced Ovarian Cancer ◽  
Cytotoxic Agents ◽  
Phase Iii ◽  
Gynecologic Oncology Group ◽  
Oncology Group

Principles and practice of intraperitoneal chemotherapy for ovarian cancer

2007 ◽  
Vol 17 (1) ◽  
pp. 1-20 ◽  
Author(s):  
K. Fujiwara ◽  
D. Armstrong ◽  
M. Morgan ◽  
M. Markman
Keyword(s):  
Ovarian Cancer ◽  
Survival Benefit ◽  
Meta Analysis ◽  
Gynecologic Oncology ◽  
Advanced Ovarian Cancer ◽  
Phase Iii ◽  
Clinical Aspects ◽  
Gynecologic Oncology Group ◽  
Oncology Group ◽  
Phase Iii Trials

Intraperitoneal (IP) chemotherapy has been studied for years to improve the survival of patients with ovarian cancer. Recently, the result of Gynecologic Oncology Group 172 trial comparing IP versus intravenous administration of cisplatin-based chemotherapy was published, demonstrating the improvement of survival benefit in favor of the IP arm. This trial is the third trial that showed a survival benefit on IP chemotherapy. The National Cancer Institute (NCI) and Gynecologic Oncology Group have done a meta-analysis on the results of these three US trials and other phase III trials of IP versus intravenous chemotherapy, and significant improvement of survival was shown with IP therapy. Based on this meta-analysis, NCI has released a clinical announcement encouraging the gynecological oncology community to consider IP chemotherapy as the standard treatment for optimally debulked advanced ovarian cancer patients. However, there still are controversial issues regarding the use of IP chemotherapy. It is important to understand how IP chemotherapy works to solve those issues in the future. In this review article, we discuss the principles and clinical aspects of IP chemotherapy and also discuss the current problems and future perspectives in IP chemotherapy

scholarly journals Quality-of-Life Comparisons in a Randomized Trial of Interval Secondary Cytoreduction in Advanced Ovarian Carcinoma: A Gynecologic Oncology Group Study

2005 ◽  
Vol 23 (24) ◽  
pp. 5605-5612 ◽  
Author(s):  
Lari Wenzel ◽  
Helen Q. Huang ◽  
Bradley J. Monk ◽  
Peter G. Rose ◽  
David Cella
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Randomized Trial ◽  
Gynecologic Oncology ◽  
Phase Iii ◽  
Gynecologic Oncology Group ◽  
Oncology Group ◽  
The Third

Purpose To compare self-reported quality of life (QOL) in patients who did versus did not undergo interval secondary cytoreduction after initial surgery and combination chemotherapy for advanced ovarian cancer and to assess the association between baseline QOL scores and survival. Patients and Methods Consenting patients participating in a Gynecologic Oncology Group (GOG) phase III treatment trial (GOG 152) completed the Functional Assessment of Cancer Therapy–Ovarian (FACT-O) questionnaire and treatment-specific supplemental questions at the third and sixth chemotherapy cycles and at 6 and 12 months after starting treatment. Results For all patients, QOL decreased approximately 1 unit from the first to second assessment. Significant improvement observed at 6 months (P < .001) was sustained at 12 months, with no appreciable between-group difference. The baseline FACT-O score was associated with overall survival (P = .048) but not progression-free survival. Less neurotoxicity was reported among patients who did (38.4%) versus did not (54.0%) undergo interval secondary cytoreduction at the third assessment (P = .005), and older patients experienced more long-term effects. Conclusion This is the first multicenter randomized trial in ovarian cancer to longitudinally examine self-reported QOL and establish a predictive value of baseline QOL on survival, attributed primarily to the lowest-scoring quartile. Although interval secondary cytoreduction resulted in no notable long-term difference, a clinically significant improvement was seen in both arms at 6 and 12 months after starting therapy. Interestingly, there were fewer complaints of neurotoxicity at 6 months among patients who did versus did not undergo interval secondary cytoreduction.

Analysis of the cost-effectiveness of paclitaxel as alternative combination therapy for advanced ovarian cancer.

1997 ◽  
Vol 15 (2) ◽  
pp. 640-645 ◽  
Author(s):  
W McGuire ◽  
A I Neugut ◽  
S Arikian ◽  
J Doyle ◽  
C M Dezii
Keyword(s):  
Ovarian Cancer ◽  
Survival Time ◽  
Pharmacoeconomic Analysis ◽  
Gynecologic Oncology ◽  
Alternative Therapy ◽  
Advanced Ovarian Cancer ◽  
Cost Effective ◽  
Phase Iii ◽  
Gynecologic Oncology Group ◽  
Kaplan Meier

PURPOSE A phase III trial by the Gynecologic Oncology Group (GOG) provides strong evidence that a new alternative therapy--paclitaxel (Taxol; Bristol-Myers Squibb Co, Princeton, NJ) in combination with cisplatin (Platinol; Bristol-Myers Squibb Co)--is clinically more effective than the standard therapy using cyclophosphamide (Cytoxan; Bristol-Myers Squibb Co) in combination with cisplatin in the treatment of advanced ovarian cancer. We conducted a pharmacoeconomic analysis to determine whether the alternative paclitaxel-cisplatin (TP) therapy is cost-effective (CE) in comparison to standard cyclophosphamide-cisplatin (CP) therapy. METHODS Using an economic model, we applied cost data figures to resource utilization data derived from the two arms of the GOG trial. We examined paclitaxel benefits in terms of increased mean survival time, as well as median survival time. Estimates of the cumulative proportion surviving in the trial were based on Kaplan-Meier procedures. RESULTS Per year of life gained (YLG), TP therapy costs more ($19,820 more for inpatient treatment; $21,222 outpatient) than CP treatment. CONCLUSION The TP regimen's increased mean survival cost per YLG (inpatient and outpatient settings) adds a substantial benefit at an acceptable cost compared with CP therapy.

scholarly journals ASCO Value Framework Highlights the Relative Value of Treatment Options in Ovarian Cancer

2017 ◽  
Vol 13 (12) ◽  
pp. e1030-e1039 ◽  
Author(s):  
Jonathan Foote ◽  
Angeles Alvarez Secord ◽  
Margaret Liang ◽  
David E. Cohn ◽  
Elizabeth Jewell ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Clinical Benefit ◽  
Treatment Options ◽  
Gynecologic Oncology ◽  
Additional Cost ◽  
Phase Iii ◽  
Gynecologic Oncology Group ◽  
Oncology Group ◽  
Relative Value ◽  
Dose Dense

Purpose: The ASCO value framework allows physicians and patients to compare the relative value of novel treatments. Our aim was to assess the value of three frontline ovarian cancer therapies by using this framework. Methods: From phase III, randomized controlled clinical trial (RCT) data, the net health benefits (NHBs) for three frontline ovarian cancer treatment options—dose-dense paclitaxel (Japanese Gynecologic Oncology Group study JGOG 3016), intraperitoneal (IP)/intravenous (IV) chemotherapy (Gynecologic Oncology Group [GOG] study GOG 172), and concurrent plus maintenance bevacizumab (GOG 218 and the Seventh International Collaborative Ovarian Neoplasm study [ICON7])—were calculated. The ASCO value framework calculates the NHB by using six criteria: clinical benefit, toxicity, tail of the curve, symptom palliation, treatment-free interval, and quality of life. Clinical benefit calculation uses ASCO-assigned importance weights for overall survival and progression-free survival. The maximum possible NHB points is 180. NHBs were presented alongside the drug-acquisition cost (DAC) of each therapy. A benefit-cost ratio of NHB points per additional cost was calculated. Results: The NHB of dose-dense paclitaxel was 38, at an additional cost of $16 per cycle. IP cisplatin/IV + IP paclitaxel received 29 NHB points, at an additional cost of $1,629 per cycle. Concurrent plus maintenance bevacizumab received 24 NHB points, at an additional cost of $7,581 per cycle (GOG 218) or six NHB points ($3,790 per cycle; ICON7). The ratios of NHB points–to-dollar were as follows: dose-dense paclitaxel, 2.4 (highest); IP chemotherapy, 0.018; and bevacizumab, 0.003 (lowest). Conclusion: Using the ASCO value framework, we constructed value snapshots of three major frontline therapeutic options in ovarian cancer. Dose-dense paclitaxel provided the highest additional value when analysis accounted for NHB and cost. However, additional research is needed to include individual patient preferences and provide personalized value assessments.

Incorporation of bevacizumab in the treatment of recurrent and metastatic cervical cancer: A phase III randomized trial of the Gynecologic Oncology Group.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 3-3
Author(s):  
Krishnansu Sujata Tewari ◽  
Michael Sill ◽  
Harry J. Long ◽  
Lois M. Ramondetta ◽  
Lisa Michelle Landrum ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Randomized Trial ◽  
Annual Meeting ◽  
Gynecologic Oncology ◽  
Phase Iii ◽  
Gynecologic Oncology Group ◽  
Oncology Group ◽  
Daily News ◽  
Online Supplement ◽  
Final Text

3 The full, final text of this abstract will be available at abstract.asco.org at 7:30 AM (EDT) on Sunday, June, 2, 2013, and in the Annual Meeting Proceedings online supplement to the June 20, 2013, issue of Journal of Clinical Oncology. Onsite at the Meeting, this abstract will be printed in the Sunday edition of ASCO Daily News.

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