Fifth Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup: recurrent disease

Area of Science:

• Gynecology
• Oncology
• Clinical Trials

Background:

• Recurrent ovarian cancer (ROC) presents unique challenges in clinical trial design.
• The fifth Ovarian Cancer Consensus Conference (OCCC) convened to address critical questions in ROC research.
• Previous trial categorizations and endpoint selections required re-evaluation for improved patient stratification and outcome assessment.

Framework:

• Introduced therapy-free interval (TFI) as a replacement for platinum-free interval (PFI) to better define patient subgroups.
• TFI is further categorized into TFIp (platinum-free), TFInp (non-platinum-free), and TFIb (biological agent-free).
• Additional stratification factors include histology, BRCA mutation status, prior treatment history, surgical outcomes, and patient-reported symptoms.

Implementation:

• Established guidelines for control arms in ROC trials, recommending platinum-based therapy or non-platinum agents based on clinical context.
• Incorporated anti-angiogenic agents or poly (ADP-ribose) polymerase (PARP) inhibitors into control arm considerations.
• Defined preferred endpoints: Overall Survival (OS) for shorter median OS (< or = 12 months) and Progression-Free Survival (PFS) for longer median OS (> 12 months).

Implications:

• The updated framework aims to enhance the precision and relevance of clinical trials for recurrent ovarian cancer.
• Revised subgrouping and endpoint selection will facilitate more accurate assessment of treatment efficacy.
• These consensus statements provide a crucial update for researchers and clinicians managing ROC, potentially improving therapeutic strategies and patient outcomes.