April 11, 2016 – Many members of the ovarian cancer community have been concerned about the results of GOG 252 clinical trial, which were released last month at the Society of Gynecologic Oncology’s Annual Meeting on Women’s Cancer. OCRFA consulted with a team of our scientific experts, and the consensus of the group is that the results of this trial do not mean that patients and doctors should abandon IP chemotherapy at this time.
GOG 252 is a phase III clinical trial of bevacizumab with intravenous (IV) vs. intraperitoneal (IP) chemotherapy for ovarian, fallopian tube, and peritoneal carcinoma. The results, presented in March, showed median progression-free survival (PFS) of approximately 27 to 29 months in patients with optimal stage II-III disease treated with regimens consisting of different combinations of IV and IP cisplatin, carboplatin, and paclitaxel, in combination with bevacizumab. An analysis limited to patients with optimal stage III tumors and no gross residual disease produced median PFS values of 31 to 34 months.
These results were surprising, and in contrast to the results of the decade-old GOG 172 trial, which also compared IP and IV chemotherapy regimens in ovarian cancer. GOG 172 produced a median PFS of 23.8 months with IP cisplatin, but more notably, a PFS of 60.4 months in patients who had no visible residual disease after surgery.
The recent results, which were in such stark contrast to the previous result, have left both patients and doctors alike scratching their heads. Our scientific advisors don’t believe that the results of this one trial should outweigh the significant prior evidence that suggests that IP chemotherapy is beneficial. The best evidence to date suggests that the ideal treatment for women is optimal debulking followed by IP chemotherapy. At the very least, until results of ongoing trials are known, IP chemotherapy should still be offered to women who are likely to be able to tolerate the significant toxicities associated with the treatment.
OCRFA believes that like all good research, the results of GOG 252 raise more important questions for the ovarian cancer research community to tackle. A better understanding of the biology of ovarian cancers, and new strategies for prevention and treatment, are essential to improve the outcomes of those affected by ovarian cancer.