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SCORPION - Survival

Survival analyses from a randomized trial of primary debulking surgery versus neoadjuvant chemotherapy for advanced epithelial ovarian cancer with high tumor load (SCORPION trial).

Date of Publication:

May 20, 2018

Pubmed Link:
https://ascopubs.org/doi/abs/10.1200/JCO.2018.36.15_suppl.5516
Hypothesis:

NACT/IDS is superior to PDS in patients with high tumor load (HTL) in terms of PFS

Control Arm(s):

PDS followed by adjuvant chemo- Carbo AUC 5/ Paclitaxel 175 mg/m2 q 21 days x 6 cycles - Started within 4 wks of surgery Bevacizumab allowed

Experimental Arm(s):

NACT followed by IDS- Carbo AUC 5/ Paclitaxel 175 mg/m2 q 21 days x 3-4 cycles then IDS within 4 weeks- Chemo resumed within 4 wks after IDS for total of 6 cycles Bevacizumab allowed

Primary End Point:

PFS

Inclusion Criteria:

'- stage IIIC or IV ovarian cancer (stage IV only if resectable disease)- 18- 75 yrs old- Intraop - EOC on frozen - Predictive index (PI) score 8-12 (High tumor load)(Taken from original publication of peri-operative outcomes)

Exclusion Criteria:

'- Pregnancy/breastfeeding- Concomitant or previous malignancy in last 5 yrs- Borderline or non-epithelial tumor- Mets from another primary- Mesenteric retraction regardless of PI- PI <8 or >12(Taken from original publication of peri-operative outcomes)

Results:

'- 171 randomized to PDS (n=84) vs NACT (n=87)- Median FU 42 mo- PFS- 15 mo (PDS) vs 14 mo (NACT) (NS)- Median OS- 41 mo (PDS) vs Not reached (NACT)- Optimal residual tumor (<1 cm)- 93% (PDS) vs 100% (IDS)- (SS)- Postop death- 8% (PDS) vs 0 (IDS)- (SS)

Conclusions:

NACT was not superior in PFS for advanced EOC with high tumor load

Reviewer:
Courtney Bailey