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Adjuvant Chemotherapy Ups Survival in High-Risk Early Ovarian Cancer

Adjuvant Chemotherapy Ups Survival in High-Risk Early Ovarian Cancer

LISBON, Portugal—Adjuvant platinum-based chemotherapy significantly
improves the outlook for women with high-risk early-stage epithelial ovarian
cancer, according to the findings of two parallel, randomized phase III trials
presented at the 11th European Cancer Conference (ECCO abstract 1019).

The first International Collaboration on Ovarian Neoplasms (ICON-1) trial
was carried out under the joint auspices of the UK Medical Research Council,
the Mario Negri Institute for Pharmacological Research, and the Swiss Institute
for Applied Cancer Research. The Adjuvant Clinical Trial in Ovarian Neoplasms (ACTION) study was sponsored by the European Organization for Research and
Treatment of Cancer (EORTC).

The goal of both trials was to compare the impact on survival of initiating
adjuvant chemotherapy after surgical resection vs delaying chemotherapy until
relapse.

Speaking on behalf of the ICON-1 and ACTION investigators, coordinator Chris
Williams, MD, explained that ICON-1, with 477 participants, was designed as a
pragmatic study that was open to any patient whose physician was uncertain
about whether to institute adjuvant chemotherapy.

In contrast, ACTION, which included 448 patients, was more restrictive,
enrolling only those women with FIGO stage Ia or Ib and grade 2 or 3 disease,
or stage Ic or IIa and any grade disease, or clear cell tumors. "There was
more diversity and heterogeneity in the ICON-1 study because of the requirement
of more careful selection and staging in the ACTION study," Dr. Williams noted.

More Than 90% Were Stage I

The total of 925 patients, whose median age was 55 years, were recruited at
124 centers in 13 countries over the course of nearly a decade. "It’s
worth noting that more than 90% of patients had FIGO stage I disease," Dr.
Williams said.

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