Hormone therapy shows big promise for ovarian cancer patients

For women with a rare subtype of epithelial ovarian or peritoneum cancer, known as low-grade serous carcinoma (LGSC), hormone maintenance therapy (HMT) may significantly improve survival, according to a new study from MD Anderson.

The research was published in the Journal of Clinical Oncology and has been updated since it was first presented at the 2016 Annual Meeting of the American Society of Clinical Oncology.

According to the researchers, LGSC accounts for just 10% of serous carcinomas of the ovary/peritoneum. It is typically diagnosed in older women, but occurs in some who are in their 40s and 50s. Teenagers and women in their 20s and 30s also have been diagnosed. Patients usually present with advanced disease.

“There is a true unmet need for these patients — roughly 70 percent of women with this disease will experience a recurrence of the cancer at some point,” said David M. Gershenson, M.D., professor of Gynecologic Oncology and Reproductive Medicine. “Our group published research demonstrating that hormonal therapy showed promise in the recurrent setting, with most patients responding or having stable disease. It was a natural progression over time that we began to study this up front, after women received their primary chemotherapy.”

Should this new retrospective data be validated in a randomized study, the findings could one day represent a significant improvement to frontline standard of care.

MD Anderson has a long history of discovery in this field of rare ovarian cancer. For example, the institution’s researchers published a study in 2004 that changed the way serous carcinomas were graded, thereby identifying LGSC. MD Anderson research also showed that LGSC is relatively chemo-resistant compared to high-grade serous carcinoma, said Gershenson, the study’s corresponding author.

In this retrospective cohort study, researchers analyzed data from 203 women with Stage II-IV LGSC treated at MD Anderson between 1981 and 2013 to evaluate the effect of HMT, compared with surveillance after surgery and chemotherapy. Women who received HMT (70 patients) showed an average progression-free survival (PFS) of 64.9 months, compared with 26.4 months for those in the surveillance group (133 patients). Overall survival (OS) was 115.7 months following HMT, versus 102.7 months for the surveillance group.

Further, among 149 women who showed no evidence of disease following completion of primary chemotherapy, HMT appears to have resulted in even greater survival: 81.1 versus 30 months progression-free survival; and 191.3 versus 106.8 months overall survival.

“If confirmatory research in a clinical trial setting shows hormonal maintenance therapy can prevent or delay recurrence of this cancer subtype, it would be practice changing,” Gershenson said.

Read more about the study in MD Anderson’s Newsroom.