Correspondence: Premature Stop of the SOCceR Trial, a Multicenter Randomized Controlled Trial on Secondary Cytoreductive Surgery

Laar, Rafli van de; Zusterzeel, Petra L.M.; Gorp, Toon Van; Massuger, Leon F.A.G.

doi:10.1097/igc.0000000000000841

Cited by 12 publications

(5 citation statements)

References 3 publications

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“…Three large randomized controlled phase III trials were then launched to examine this issue further: the AGO DESKTOP III study [9], the GOG 213 study [14] and the Dutch SOCceR study [15]. Unfortunately, the SOCceR study was discontinued because the recruitment rate in the Netherlands was too low [16].…”

Section: Surgery For Recurrent Ovarian Cancermentioning

confidence: 99%

Treatment of Recurrent Epithelial Ovarian Cancer

Claussen

Rody

Hanker

2020

Geburtshilfe Frauenheilkd

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Epithelial ovarian cancer is the most common cause of death from gynecological tumors. Most patients with advanced ovarian cancer develop recurrence after concluding first-line therapy, making further lines of therapy necessary. The choice of therapy depends on various criteria such as tumor biology, the patientʼs general condition (ECOG), toxicity, previous chemotherapy, and response to chemotherapy. The platinum-free or treatment-free interval determines the potential response to repeat platinum-based therapy. If patients have late recurrence, i.e. > 6 months after the end of the last platinum-based therapy (i.e., they were previously platinum-sensitive), then they are usually considered suitable for another round of a platinum-based combination therapy. Patients who are not considered suitable for platinum-based chemotherapy are treated with a platinum-free regimen such as weekly paclitaxel, pegylated liposomal doxorubicin (PLD), gemcitabine, or topotecan. Treatment for the patient subgroup which is considered suitable for platinum-based therapy but cannot receive carboplatin due to uncontrollable hypersensitivity reactions may consist of trabectedin and PLD. While the use of surgery to treat recurrence has long been a controversial issue, new findings from the DESKTOP III study of the AGO working group have drawn attention to this issue again, particularly for patients with a platinum-free interval of > 6 months and a positive AGO score. Clinical studies have also shown the efficacy of angiogenesis inhibitors such as bevacizumab and the PARP inhibitors olaparib, niraparib and rucaparib. These drugs have substantially changed current treatment practice and expanded the range of available therapies. It is important to differentiate between purely maintenance therapy after completing CTX, continuous maintenance therapy during CTX, and the therapeutic use of these substances. The PARP inhibitors niraparib, olaparib and rucaparib have already been approved for use by the FDA and the EMA. The presence of a BRCA mutation is a predictive factor for a better response to PARP inhibitors.

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Section: Surgery For Recurrent Ovarian Cancermentioning

confidence: 99%

Treatment of Recurrent Epithelial Ovarian Cancer

Claussen

Rody

Hanker

2020

Geburtshilfe Frauenheilkd

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“…Other trials are ongoing, including the SOC 1 trial [ 16 ]. While, the SOCceR trial was spotted prematurely in August 2015 due to the lagging of inclusion [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Artificial intelligence weights the importance of factors predicting complete cytoreduction at secondary cytoreductive surgery for recurrent ovarian cancer

et al. 2018

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ObjectiveAccumulating evidence support that complete cytoreduction (CC) at the time of secondary cytoreductive surgery (SCS) improves survival in patients affected by recurrent ovarian cancer (ROC). Here, we aimed to determine whether artificial intelligence (AI) might be useful in weighting the importance of clinical variables predicting CC and survival.MethodsThis is a retrospective study evaluating 194 patients having SCS for ROC. Using artificial neuronal network (ANN) analysis was estimated the importance of different variables, used in predicting CC and survival. ANN simulates a biological neuronal system. Like neurons, ANN acquires knowledge through a learning-phase process and allows weighting the importance of covariates, thus establishing how much a variable influences a multifactor phenomenon.ResultsOverall, 82.9% of patients had CC at the time of SCS. Using ANN, we observed that the 3 main factors driving the ability of achieve CC included: disease-free interval (DFI) (importance: 0.231), retroperitoneal recurrence (importance: 0.178), residual disease at primary surgical treatment (importance: 0.138), and International Federation of Gynecology and Obstetrics (FIGO) stage at presentation (importance: 0.088). Looking at connections between different covariates and overall survival (OS), we observed that DFI is the most important variable influencing OS (importance: 0.306). Other important variables included: CC (importance: 0.217), and FIGO stage at presentation (importance: 0.100).ConclusionAccording to our results, DFI should be considered as the most important factor predicting both CC and OS. Further studies are needed to estimate the clinical utility of AI in providing help in decision making process.

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“…gov number NCT01166737), SOCceR (Netherlands Trial Register number NL3137) and SOC-1 (ClinicalTrials.gov number NCT01611766) [6]. The SOCceR trial was terminated early due to poor enrollment [7].…”

Section: Introductionmentioning

confidence: 99%

“…Subsequently, four randomized controlled trials (RCTs) were conducted to compare SCS + CT with chemotherapy alone in ROC patients: GOG-0213 (ClinicalTrials.gov number NCT00565851), DESKTOP III (ClinicalTrials.gov number NCT01166737), SOCceR (Netherlands Trial Register number NL3137) and SOC-1 (ClinicalTrials.gov number NCT01611766) [ 6 ]. The SOCceR trial was terminated early due to poor enrollment [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

The survival outcome and complication of secondary cytoreductive surgery plus chemotherapy in recurrent ovarian cancer: a systematic review and meta-analysis

Ding

Tang

2021

J Ovarian Res

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Objective The aim of this meta-analysis was to assess the effectiveness and safety of secondary cytoreductive surgery plus chemotherapy (SCS + CT) in recurrent ovarian cancer (ROC). Our secondary purpose was to analyze whether patients could benefit from complete resection. Methods We searched EMBASE, MEDLINE, the Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials, from inception to April 2021. We used appropriate scales to assess the risk of bias. Data from included studies that reported median PFS or OS were weighted by individual study sample size, and aggregated for meta-analysis. We calculated the pooled proportion of complications within 30 days after surgery. Results We identified 13 articles, including three RCTs and ten retrospective cohort studies. A total of 4572 patients were included, of which 916 patients achieved complete resection, and all patients were comparable at baseline. Compared with chemotherapy alone, SCS + CT significantly improved the PFS (HR = 0.54, 95% CI: 0.43–0.67) and OS (HR = 0.60, 95% CI: 0.44–0.81). Contrary to the results of cohort studies, the meta-analysis of RCTs showed that SCS + CT could not bring OS benefits (HR = 0.93, 95% CI: 0.66–1.3). The subgroup analysis showed the prognostic importance of complete resection. Compared with chemotherapy alone, complete resection was associated with longer PFS (HR = 0.53, 95% CI: 0.45–0.61) and OS (HR = 0.56, 95% CI: 0.39–0.81), while incomplete resection had no survival benefit. Additionally, complete resection could maximize survival benefit compared with incomplete resection (HR = 0.56, 95% CI: 0.46–0.69; HR = 0.61, 95% CI: 0.50–0.75). The pooled proportion for complications at 30 days was 21% (95% CI: 0.12–0.30), and there was no statistical difference in chemotherapy toxicity between the two groups. Conclusion The review indicated that SCS + CT based regimens was correlated with better clinical prognosis for patients with recurrent ovarian cancer, but the interpretation of OS should be cautious. The meta-analysis emphasizes the importance of complete resection, suggesting that the potential benefits of prolonging survival may outweigh the disadvantages of any short-term complications associated with surgery.

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Correspondence: Premature Stop of the SOCceR Trial, a Multicenter Randomized Controlled Trial on Secondary Cytoreductive Surgery

Cited by 12 publications

References 3 publications

Treatment of Recurrent Epithelial Ovarian Cancer

Treatment of Recurrent Epithelial Ovarian Cancer

Artificial intelligence weights the importance of factors predicting complete cytoreduction at secondary cytoreductive surgery for recurrent ovarian cancer

The survival outcome and complication of secondary cytoreductive surgery plus chemotherapy in recurrent ovarian cancer: a systematic review and meta-analysis

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