Pegylated Liposomal Doxorubicin in Recurrent Ovarian Cancer: Is There a Role for Maintenance Therapy?

IntroductionOvarian cancer is the fifth leading cause of death in women. PLD has been effective in recurrent ovarian cancer, but the ideal treatment length is unknown. We hypothesized that patients with regression or stabilization of disease while receiving PLD, who continued with prolonged treatment, would have increased PFS.Patients and MethodsA retrospective chart review was performed of women with recurrent ovarian, fallopian tube, primary peritoneal, or uterine papillary serous carcinoma, who received 6 or more cycles of PLD without evidence of progression. Evaluation for progression was based on carcinoma antigen 125, physical examination, and imaging studies.ResultsOf the 30 patients meeting criteria for inclusion, 13 patients (43%) stopped treatment at best response (median, 6 cycles) and 17 (57%) continued treatment until disease progression (median, 11 cycles). Patients treated to best response experienced a significantly shorter PFS compared with those who continued treatment until progression, median 10 versus 15 months (P = .009). There was a trend toward improved OS in the prolonged therapy group of 42.5 months (range, 12-84) versus 23 months in the standard therapy group (range, 17-98; P = .56).ConclusionOur data suggest that prolonged PLD treatment to progression is associated with a PFS advantage compared with treatment to best response. In the absence of toxicity, this treatment paradigm should be considered.