Dr. Gunderson on the GOG-252 Trial in Advanced Ovarian Cancer

Camille C. Gunderson, MD, assistant professor of gynecologic oncology, Stephenson Cancer Center, discusses the phase III open-label GOG-252 trial (NCT01167712) in advanced ovarian cancer.

No progression-free survival (PFS) or overall survival (OS) benefit was reported with the use of intraperitoneal (IP) chemotherapy compared with intravenous (IV) chemotherapy, both combined with bevacizumab (Avastin), in patients with newly diagnosed advanced ovarian cancer.

After a median follow-up of 84.4 months, PFS in the IV carboplatin group was 24.9 months compared with 27.4 moths in the IP carboplatin group (HR, 0.925; 95% CI, 0.802-1.07). A third arm of IP cisplatin was tested and yielded a PFS of 26.2 (HR, 0.977; 95% CI, 0.847-1.13).

Median OS was 75.5 months, 78.9 months, and 72.9 months, in the IV carboplatin, IP carboplatin, and IP cisplatin arms, respectively. More frequent grade ≥3 adverse events including infections, nausea, vomiting, and hypertension were seen with IP chemotherapy compared with IV chemotherapy (P = .008).

Patients with no gross residual disease and a somatic BRCA mutation, may benefit the most from IP chemotherapy, says Gunderson. However, with similar PFS and OS, the lower incidence of toxicity suggests that IV chemotherapy may be preferable to IP chemotherapy.