The influence of polypharmacy on grade III/IV toxicity, prior discontinuation of chemotherapy and overall survival in ovarian cancer

• Polypharmacy was associated with increased overall, hematological and non-hematological grade III/IV toxicities.
• Polypharmacy did not correlate with prior discontinuation of chemotherapy.
• An increasing amount of comedications did not influence overall survival.

BackgroundOvarian cancer is mostly diagnosed in the elderly woman who is likely to have comorbid disease and to take several comedications on a regular basis. Aim of this study was to evaluate the influence of polypharmacy on grade III/IV toxicity, prior discontinuation of chemotherapy and survival.Patients and methodsIn this individual participant data meta-analysis the original data of three phase II/III studies of the North-Eastern German Society of Gynecological Oncology (NOGGO) were analyzed using multivariate logistic and Cox regression.ResultsOverall, 1213 patients with recurrent ovarian cancer were included in these analyses. An increasing amount of medication was associated with overall grade III/IV toxicity (p < 0.001; OR 1.120), and hematological (p < 0.001; OR 1.056) and non-hematological (p < 0.001; OR 1.134) toxicities. Prior discontinuation of chemotherapy was not influenced by an increasing amount of medication (p = 0.196). There was no association of polypharmacy with overall survival (p = 0.068).ConclusionAs polypharmacy does not influence survival ovarian cancer patients taking several comedications may be included in clinical trials and should not be deprived of adequate cancer treatment. However, a thorough monitoring is mandatory due to the increased risk of toxicities.