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Cited by 187Ovarian cancer diagnosis and treatmentIntraperitoneal and Appendiceal MalignanciesEndometrial and Cervical Cancer Treatments

Survival benefits with diverse chemotherapy regimens for ovarian cancer: meta-analysis of multiple treatments

Kyrgiou, Maria, Salanti, Georgia, Pavlidis, Nicholas, Paraskevaidis, Evangelos, Ioannidis, John P. A.·2006·JNCI Journal of the National Cancer Institute
DOI 10.1093/jnci/djj443
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Abstract

BACKGROUND: Numerous randomized trials have compared different chemotherapy regimens in women with ovarian cancer. Although ovarian cancer survival has improved in recent years, the magnitude of these incremental benefits across diverse regimens is unclear. METHODS: We used multiple-treatment meta-analysis methodology to combine information from direct and indirect comparisons of all chemotherapy regimens used in randomized trials of ovarian cancer in the last 40 years. Chemotherapy was categorized by the use or not of platinum and/or taxanes, combinations of agents, and intraperitoneal administration. Monte Carlo simulations were used to determine which regimen most improved survival. Analyses of trials that examined first- and second-line treatments were also performed separately. RESULTS: We found 198 trials (N = 38,440 women) involving 120 different chemotherapy regimens published in 1971-2006. Eighty-two trials compared different types of chemotherapy, among which 60 had usable survival information (N = 15,609 women). Monte Carlo simulations showed a 92% probability that the regimen that best prolonged survival is a platinum and taxane combination with intraperitoneal administration; this regimen resulted in a 55% relative risk reduction (95% confidence interval [CI] = 39% to 67%) for mortality as compared with nonintraperitoneal monotherapy using neither platinum nor taxane. Against that same monotherapy comparator, platinum-based combinations with and without intraperitoneal administration achieved 40% (95% CI = 21% to 54%) and 30% (95% CI = 20% to 38%) relative risk reductions for mortality, respectively, and combinations involving platinum and taxane without intraperitoneal administration achieved a 42% (95% CI = 31% to 51%) relative risk reduction. Results were similar when analyses were limited to first-line treatment. Data on second-line treatment were consistent with the superiority of platinum and taxane combinations. CONCLUSIONS: Distinct incremental improvements in survival have been achieved for ovarian cancer chemotherapy over time, with the possibility to achieve a doubling or more of time to mortality with platinum and taxane combinations, especially when intraperitoneal administration is used.

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Authors
Kyrgiou, M., Salanti, G., Pavlidis, N., Paraskevaidis, E., & Ioannidis, J. P. A.
Affiliations
Tufts University (US)
Corresponding author
Kyrgiou, Maria
ORCID
Venue
JNCI Journal of the National Cancer Institute
Publisher
Oxford University Press (OUP)
Published
2006-11-15
Volume
98
Issue
22
Pages
1655-1663
ISSN
  • 0027-8874 (ISSN-L)
  • 1460-2105
DOI
10.1093/jnci/djj443
OpenAlex
W2099380130
Cited by
187
References
35
Citations by year
2026: 3 · 2025: 7 · 2024: 4 · 2023: 10 · 2022: 10 · 2021: 10 · 2020: 15 · 2019: 5 · 2018: 8 · 2017: 10 · 2016: 10 · 2015: 10 · 2014: 9 · 2013: 11 · 2012: 14
FWCI
1.65
Type
journal article
Language
en
Open access
closed
Locations
  • JNCI Journal of the National Cancer Institute (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
  • Health Sciences › Medicine › Surgery › Intraperitoneal and Appendiceal Malignancies
  • Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
Keywords
ovarian cancer, chemotherapy regimens, survival, platinum-based chemotherapy, taxanes, intraperitoneal chemotherapy, first-line therapy, second-line therapy, mortality, Monte Carlo simulation
MeSH terms
Antineoplastic Agents, Antineoplastic Combined Chemotherapy Protocols, Female, Humans, Infusions, Parenteral, Monte Carlo Method, Organoplatinum Compounds, Ovarian Neoplasms, Survival Analysis, Randomized Controlled Trials as Topic, Taxoids

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