Race does not impact outcome for advanced ovarian cancer patients treated with cisplatin/paclitaxel

An Analysis of Gynecologic Oncology Group Trials

Authors

  • John H. Farley MD,

    Corresponding author
    1. Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Maryland
    • Uniformed Serviced University of Health Sciences, Department of Obstetrics and Gynecology, 4301 Jones Bridge Road, Bethesda, MD 20832
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    • Fax: (301)295-0814

  • Chunqiao Tian MD,

    1. Gynecologic Oncology Group Statistical and Data Center, Roswell Park Cancer Institute, Buffalo, New York
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  • G. Scott Rose MD,

    1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, and the United States Military Cancer Institute, Walter Reed Army Medical Center, Washington, DC
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  • Carol L. Brown MD,

    1. Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
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  • Michael Birrer MD, PhD,

    1. Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
    Current affiliation:
    1. Dr. Michael Birrer's current address is Massachusetts General Hospital, Boston, Massachusetts
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  • G. Larry Maxwell MD

    1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, and the United States Military Cancer Institute, Walter Reed Army Medical Center, Washington, DC
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  • The following Gynecologic Oncology Group member institutions participated in this study: University of Alabama at Birmingham; Duke University Medical Center; Abington Memorial Hospital; University of Rochester Medical Center; Walter Reed Army Medical Center; Wayne State University; University of Minnesota Medical School; Emory University Clinic; University of Mississippi Medical Center; Colorado Gynecologic Oncology Group, P.C.; University of California at Los Angeles; University of Washington; University of Pennsylvania Cancer Center; Milton S. Hershey Medical Center; Georgetown University Hospital; University of Cincinnati; University of North Carolina School of Medicine; University of Texas Southwestern Medical Center at Dallas; Indiana University School of Medicine; Wake Forest University School of Medicine; Albany Medical College; University of California Medical Center at Irvine; Tufts-New England Medical Center; Rush-Presbyterian–St. Luke's Medical Center; State University of New York Downstate Medical Center; University of Kentucky; Community Clinical Oncology Program, the Cleveland Clinic Foundation; Johns Hopkins Oncology Center; State University of New York at Stony Brook; Eastern Pennsylvania GYN/ONC Center, P.C.; Washington University School of Medicine; Cooper Hospital/University Medical Center; Columbus Cancer Council; University of Massachusetts Medical School; Fox Chase Cancer Center; Medical University of South Carolina; Women's Cancer Center, University of Oklahoma; University of Virginia Health Sciences Center; University of Chicago; Tacoma General Hospital, Thomas Jefferson University Hospital; Case Western Reserve University; Tampa Bay Cancer Consortium; North Shore University Hospital; Gynecologic Oncology Network; Oregon Health Sciences University; University of Southern California at Los Angeles; University of Miami School of Medicine; Stanford University Medical Center; Eastern Virginia Medical School; University of Arizona Health Science Center; Mayo Clinic; and Long Island Jewish Medical Center.

  • This article is US Government work and, as such, is in the public domain in the United States of America.

Abstract

BACKGROUND:

The objectives of this study were to confirm whether racial disparity exists with regard to outcome between black women and white women with ovarian cancer and to identify factors associated with the administration of adjuvant treatment that had an impact on survival.

METHODS:

A retrospective review of 97 black women and 1392 white women with International Federation of Gynecology and Obstetrics stage III/IV ovarian carcinoma was performed. All patients received paclitaxel combined with cisplatin while participating in 1 of 7 Gynecologic Oncology Group clinical trials. The treatment parameters that were reviewed included relative dose, relative time, and relative dose intensity. The treatment parameters and outcomes were compared between black patients and white patients.

RESULTS:

There were no differences in relative dose (0.90 vs 0.89), relative time (1.02 vs 0.99), or relative dose intensity (0.90 vs 0.91) received between black patients and white patients. Black women had less grade 3 and 4 leukopenia (53% vs 63%; P < .05) and gastrointestinal toxicity (10% vs 19%; P < .05) than white women. Performance status >0, age ≥70 years, and mucinous histology were associated with not completing treatment (P < .001). The median progression-free survival was 16.2 months for black patients and 16.1 months for white patients, and the median overall survival was 37.9 months and 39.7 months, respectively (P > .05 for all).

CONCLUSIONS:

When they received similar treatment, there was no difference in clinical outcome between black women and white women with advanced stage epithelial ovarian cancer when they received similar treatment as participants in Gynecologic Oncology Group clinical trials. Black patients may experience less severe gastrointestinal toxicity or leukopenia compared with whites when treated with platinum-based chemotherapy. Cancer 2009. Published 2009 by the American Cancer Society.

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