PARAGON: A Phase II study of anastrozole in patients with estrogen receptor-positive recurrent/metastatic low-grade ovarian cancers and serous borderline ovarian tumors

Tang, Mónica; O’Connell, Rachel; Amant, Frédéric; Beale, Philip; McNally, Orla; Sjoquist, Katrin Marie; Grant, Peter; Davis, Alison; Sykes, Peter; Mileshkin, Linda; Moujaber, Tania; Kennedy, Catherine J.; deFazio, Anna; Tan, King; Antill, Yoland; Goh, Jeffrey C.; Bonaventura, Tony; Scurry, James; Friedlander, Michael

doi:10.1016/j.ygyno.2019.06.011

Cited by 65 publications

(51 citation statements)

References 43 publications

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“…12 Schmeler et al 12 with SBOT that recurred as LGSOC and two with low-grade endometrioid cancers) were enrolled and a clinical benefit at three and six months was seen in 64% and 61% with a PR in 14%, SD in 50% and PD in 36%; PFS was 11.1 months. 38 The PR rate of 14% seen in PARAGON is comparable with a series of 64 patients treated with anastrozole, letrozole or tamoxifen which showed an ORR of 9%, SD in 62% and a median PFS of 7.4 months. 39 Given the indolent disease biology it is difficult to ascertain if the rates of stable disease are secondary to this or treatment effect.…”

Section: Chemotherapysupporting

confidence: 62%

“…Regarding recurrence, the recently published prospective PARAGON trial investigating anastrozole in post‐menopausal patients with ER positive and/or PR positive recurrent or metastatic gynaecological cancers included seven Phase II studies within a single basket protocol . A total of 36 patients (32 with LGSOC, two with SBOT that recurred as LGSOC and two with low‐grade endometrioid cancers) were enrolled and a clinical benefit at three and six months was seen in 64% and 61% with a PR in 14%, SD in 50% and PD in 36%; PFS was 11.1 months …”

Section: Clinical Course and Treatmentmentioning

confidence: 99%

“…The PFS of MHT was higher (64.9 vs 26.4 months); however, this did not translate into a statistically significant improvement in OS (115.7 vs 102.7 months) 9. Regarding recurrence, the recently published prospective PARAGON trial investigating anastrozole in post-menopausal patients with ER positive and/or PR positive recurrent or metastatic gynaecological cancers included seven Phase II studies within a single basket protocol 38. A total of 36 patients (32 with LGSOC, two…”

mentioning

confidence: 99%

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Low‐grade serous ovarian carcinoma: A comprehensive literature review

Goulding

Simcock

McLachlan

et al. 2019

Aust NZ J Obst Gynaeco

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Background Low‐grade serous ovarian carcinoma (LGSOC) is a unique entity with clinical and molecular characteristics distinct from high‐grade serous ovarian carcinoma (HGSOC). To date the majority of research has focused on the more common HGSOC, with treatment recommendations often extrapolated to LGSOC. Women with LGSOC are typically diagnosed younger and have indolent and relatively chemoresistant disease. Recently there have been major research advances in LGSOC. Aims This systematic review describes the epidemiological, clinical and molecular characteristics of LGSOC, with advances in research and novel treatment options also discussed. Materials and Methods A 10‐year comprehensive systematic review of peer‐reviewed literature was conducted, with a total of 132 abstracts read, 89 articles reviewed and 49 included in this review. Results This review highlights the clinical and molecular features of LGSOC, current and traditional treatment options and areas of current research into targeted agents. Conclusions Our growing knowledge about LGSOC as a distinct clinical and molecular entity from HGSOC has led to the investigation of more targeted and tailored therapies as their clinical course, optimal management and therapeutic targets differ. There is a need for ongoing collaborative research to provide better treatment options for these patients.

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Section: Chemotherapysupporting

confidence: 62%

Section: Clinical Course and Treatmentmentioning

confidence: 99%

mentioning

confidence: 99%

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Low‐grade serous ovarian carcinoma: A comprehensive literature review

Goulding

Simcock

McLachlan

et al. 2019

Aust NZ J Obst Gynaeco

Self Cite

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“…The PARAGON (ANZGOG-0903), as a prospective phase II study, tested the activity of anastrozole in ER/PR-positive recurrent gynaecological tumours as a basket trial. It has shown a 6-month clinical benefit rate (CBR) of 61%, a 12-month CBR of 34% and median PFS of 11.1 months in LGOC and borderline tumours (36 patients) [ 30 ].…”

Section: Hormonotherapymentioning

confidence: 99%

Rare ovarian tumours. Other treatments for ovarian cancer

Gil-Martín

Pardo

Barretina-Ginesta

2020

European Journal of Cancer Supplements

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Aim The description of rare malignant ovarian tumours and the most suitable treatments. Alternative therapies different from intravenous chemotherapy are also explained. Methods Literature review and ongoing trial information have been used to elaborate this guide. Results Each ovarian cancer type must be identified and treated properly from diagnostic to surgery, adjuvant treatment and metastatic disease. Hormonotherapy can be useful as an alternative treatment, especially in low-grade ovarian cancer and endometrioid subtype. Tumour characterisation is appropriated for treatment selection when targeted therapy is indicated. MEK inhibitors, tyrosine-kinase inhibitors, EGFR inhibitors, therapies against integrins, antibody–drug conjugates and other strategies are described. Antiangiogenics, PARP inhibitors and immunotherapy are discussed in other parts of this publication. Conclusion Different ovarian cancer types must receive the appropriated treatment. Alternative therapies may be evaluated beyond the standard therapy, frequently in a clinical trial, and an individualised molecular study may help to find the best treatment.

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“…Hormonal therapies have been investigated as maintenance therapy after chemotherapy in the adjuvant setting,40 as primary adjuvant therapy,41 and as treatment for recurrent disease (Table 2). 42 43 A hormonal maintenance study retrospectively evaluated 70 stage II to IV low-grade serous ovarian carcinoma patients who received various hormonal therapies after debulking surgery and post-operative chemotherapy 40. A control group consisted of 130 low-grade serous ovarian carcinoma patients treated at the same institution with debulking surgery and post-operative chemotherapy but without hormonal maintenance therapies 40.…”

Section: Hormonal Therapymentioning

confidence: 99%

Low-grade serous ovarian carcinoma: an evolution toward targeted therapy

Voutsadakis

2019

Int J Gynecol Cancer

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Low-grade serous ovarian carcinoma and its high-grade serous ovarian carcinoma counterpart differ in their precursor lesions, molecular profile, natural history, and response to therapies. As such, low-grade serous ovarian carcinoma needs to be studied separately from high-grade serous ovarian carcinoma, despite challenges stemming from its rarity. A deeper understanding of the pathogenesis of low-grade serous ovarian carcinoma and the most common molecular defects and pathways involved in the carcinogenesis of the ovarian epithelium from normal to serous borderline ovarian tumors to low-grade serous ovarian carcinoma will help develop better therapies. By adopting targeted approaches there may be an opportunity to integrate novel therapies without the need for robust numbers in clinical trials. This manuscript will discuss low-grade serous ovarian carcinoma and focus on the arising treatments being developed with an improved understanding of the pathogenesis of this disease.

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PARAGON: A Phase II study of anastrozole in patients with estrogen receptor-positive recurrent/metastatic low-grade ovarian cancers and serous borderline ovarian tumors

Cited by 65 publications

References 43 publications

Low‐grade serous ovarian carcinoma: A comprehensive literature review

Low‐grade serous ovarian carcinoma: A comprehensive literature review

Rare ovarian tumours. Other treatments for ovarian cancer

Low-grade serous ovarian carcinoma: an evolution toward targeted therapy

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