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Letrozole Maintenance Therapy Improves RFS in Ovarian Cancer

Jason Harris
Published: Thursday, Jan 04, 2018

Women with ER-positive advanced high-grade serous ovarian cancer assigned to maintenance therapy with letrozole (Femara) were more likely to be recurrence-free at 24 months. These findings suggest that letrozole may have a role to play in this setting, especially for patients with chemotherapy resistance or residual disease.

In the overall study, investigators working in Australia and Switzerland performed a retrospective analysis on data from 4278 patients collected in 4 cohorts:
  • ESR1 gene expression was measured in the publicly available US-American TCGA and the Australian Tothill datasets (cohort A; n = 527)
  • ER expression in HGSOC FIGO III/IV cancer patients was measured in another US-American cohort from Caris Life Sciences (cohort B; n = 4071)
  • primary and matched recurrent HGSOC FIGO stage III/IV patients were examined for ER expression (cohort C; n = 80)
  • all newly diagnosed HGSOC FIGO III/IV with positive ER expression using IHC were prospectively included in the investigators’ single-site letrozole maintenance treatment approach at the University Hospital Basel, Gynecological Cancer Centre (cohort D; n = 50)
Since 2013, all newly diagnosed HGSOC FIGO III/IV patients with ER positive cancers equal or above 1% treated at University Hospital Basel have been offered 2.5 mg of daily letrozole as an off-label maintenance treatment following debulking surgery and adjuvant platinum-based chemotherapy.

Almost half of FIGO III/IV US-American patients with high-grade serous ovarian cancer (cohort B; n = 4071) expressed ER-positivity as measured by IHC. The ER-expression pattern was similar at different treatment sites, and therefore had no effect on the overall result.
Heinzelmann-Schwarz V, Mészaros AK, Stadlmann S, et al. Letrozole may be a valuable maintenance treatment in high-grade serous ovarian cancer patients [published online November 17, 2017]. Gynecol Oncol. doi: 10.1016/j.ygyno.2017.10.036.

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