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Chemotherapy intensity and toxicity among black and white women with advanced and recurrent endometrial cancer†‡§

A Gynecologic Oncology Group Study

  1. John H. Farley MD1,‖,*,
  2. Chunqiao Tian MS2,
  3. G. Scott Rose MD1,
  4. Carol L. Brown MD3,
  5. Michael Birrer MD, PhD4,
  6. John I. Risinger PhD5,
  7. J. Tate Thigpen MD6,
  8. Gini F. Fleming MD7,
  9. Holly H. Gallion MD8,
  10. G. Larry Maxwell MD9

Article first published online: 18 NOV 2009

DOI: 10.1002/cncr.24769

Issue

Cancer

Cancer

Volume 116, Issue 2, pages 355–361, 15 January 2010

Additional Information

How to Cite

Farley, J. H., Tian, C., Rose, G. S., Brown, C. L., Birrer, M., Risinger, J. I., Thigpen, J. T., Fleming, G. F., Gallion, H. H. and Maxwell, G. L. (2010), Chemotherapy intensity and toxicity among black and white women with advanced and recurrent endometrial cancer. Cancer, 116: 355–361. doi: 10.1002/cncr.24769

Author Information

  1. 1

    Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, Maryland

  2. 2

    Biostatistician, Gynecologic Oncology Group Statistical and Data Center, Roswell Park Cancer Institute, Buffalo, New York

  3. 3

    Gynecology Service, Department of Surgery, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Memorial Sloan-Kettering Cancer Center, New York, New York

  4. 4

    Center for Cancer Research, National Cancer Institute, Bethesda, Maryland

  5. 5

    Department of Laboratory Oncology Research, Curtis and Elizabeth Anderson Cancer Institute, Memorial Health University Medical Center, Savannah, Georgia

  6. 6

    Division of Oncology, Department of Medicine, University of Mississippi School of Medicine, Jackson, Mississippi

  7. 7

    Department of Medicine, University of Chicago, Chicago, Illinois

  8. 8

    Department of Obstetrics and Gynecology, and Reproductive Services, University of Pittsburgh-Magee Women's Research Institute, Pittsburgh, Pennsylvania

  9. 9

    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, and the United States Military Cancer Institute, Walter Reed Army Medical Center, Washington, District of Columbia

  1. ‖

    Fax: (301) 295-0814

*Uniformed Services University of the Health Sciences, Department of Obstetrics and Gynecology, 4301 Jones Bridge Road, Bethesda, MD 20832

  1. †

    Portions of this report were presented at the Thirty-Ninth Annual Meeting of the Society of Gynecologic Oncologists, held in Tampa, Florida, 2008, and published in Gynecologic Oncology 2008;108:S1, S19.

  2. ‡

    The views expressed herein are those of the authors and do not reflect the official policy or opinion of the Department of Defense or the United States Army or Navy.

  3. §

    The study was presented to and approved by local institutional review boards before activation, and all patients provided written consent before enrollment on the study.

  4. The following Gynecologic Oncology Group member institutions participated in the primary treatment studies: Wake Forest University School of Medicine, Columbus Cancer Council, University of California Medical Center at Irvine, Duke University Medical Center, Wayne State University, Indiana University Medical Center, University of Kentucky, Washington University School of Medicine, Abington Memorial Hospital, University of Iowa Hospitals and Clinics, Tufts-New England Medical Center, University of Mississippi Medical Center, Milton S. Hershey Medical Center, Rush-Presbyterian-St. Luke's Medical Center, Albany Medical College, University of Texas Southwestern Medical Center at Dallas, Community Clinical Oncology Program, University of Oklahoma, University of Minnesota Medical School, University of Virginia, The Cleveland Clinic Foundation, University of Alabama at Birmingham, Colorado Gynecologic Oncology Group, University of North Carolina School of Medicine, University of Massachusetts Medical School, Fox Chase Cancer Center, Women's Cancer Center, SUNY at Stony Brook, Medical University of South Carolina, Johns Hopkins Oncology Center, Cooper Hospital/University Medical Center, University of Chicago, Walter Reed Army Medical Center, Tampa Bay Cancer Consortium, University of Rochester Medical Center, Eastern Pennsylvania GYN/ONC Center, Tacoma General Hospital, Thomas Jefferson University Hospital, Case Western Reserve University, University of Cincinnati, University of Pennsylvania Cancer Center, Gynecologic Oncology Network, Georgetown University Hospital, Mayo Clinic, Oregon Health Sciences University, University of Miami School of Medicine, University of California at Los Angeles, SUNY Upstate Medical Center, Eastern Virginia Medical School, M.D. Anderson Cancer Center, Ellis Fischel Cancer Center, SUNY Downstate Medical Center, Emory University Clinic, University of Southern California at Los Angeles, Stanford University Medical Center, Memorial Sloan-Kettering Cancer Center, University of Washington, North Shore University Hospital, and Long Island Jewish Medical Center.

Publication History

  1. Issue published online: 20 JAN 2010
  2. Article first published online: 18 NOV 2009
  3. Manuscript Accepted: 26 MAY 2009
  4. Manuscript Revised: 18 MAY 2009
  5. Manuscript Received: 5 FEB 2009

Funded by

  • National Cancer Institute grants to the Gynecologic Oncology Group Administrative Office. Grant Number: CA 27,469
  • Gynecologic Oncology Group Statistical Office. Grant Number: CA 37,517

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Keywords:

  • endometrial cancer;
  • chemotherapy;
  • GOG

Black patients with advanced stage or recurrent endometrial cancer, treated on 4 Gynecologic Oncology Group (GOG) protocols, had similar dose intensity and severe chemotherapy-related toxicity compared with white patients. This suggests that previously described racial disparities in survival among patients in GOG trials may have a novel etiology.

Abstract

BACKGROUND:

The purpose of this study was to confirm whether black and white women with endometrial cancer are equally tolerant of chemotherapy and identify factors that impact survival.

METHODS:

A retrospective review of 169 black women and 982 white women with the International Federation of Gynecologists and Obstetricians stage III, stage IV, or recurrent endometrial carcinoma was performed. All patients received doxorubicin combined with cisplatin. Chemotherapy parameters that were reviewed included relative dose, relative time, and relative dose intensity. Treatment cycles ≥7 were defined as treatment completion.

RESULTS:

Although black patients were more likely to experience grades 3-4 anemia (20% vs 14%) and genitourinary (5% vs 1%) toxicity, and less likely to experience severe gastrointestinal toxicity (10% vs 17%), the overall incidence of grades 3-4 treatment-related chemotoxicity was the same between the 2 groups (82% vs 82%). There were no differences in the number of cycles received, relative dose (0.57 vs 0.58), relative time (0.77 vs 0.78), or relative dose intensity (0.76 vs 0.76) for black and white patients.

CONCLUSIONS:

Black patients with advanced stage or recurrent endometrial cancer, treated on 4 Gynecologic Oncology Group (GOG) protocols, had similar dose intensity and severe chemotherapy-related toxicity compared with white patients, suggesting that previously described racial disparities in survival among patients in GOG trials may have an novel etiology. Cancer 2010. © 2010 American Cancer Society.

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