Prognostic significance of ethnicity and age in advanced stage epithelial ovarian cancer: An NRG oncology/gynecologic oncology group study

Gynecol Oncol. 2022 Feb;164(2):398-405. doi: 10.1016/j.ygyno.2021.11.013. Epub 2021 Nov 29.

Abstract

Background: Age and ethnicity are among several factors that influence overall survival (OS) in ovarian cancer. The study objective was to determine whether ethnicity and age were of prognostic significance in women enrolled in a clinical trial evaluating the addition of bevacizumab to front-line therapy.

Methods: Women with advanced stage ovarian, primary peritoneal, or fallopian tube cancer were enrolled in a phase III clinical trial. All women had surgical staging and received adjuvant chemotherapy with one of three regimens. Cox proportional hazards models were used to evaluate the relationship between OS with age and race/ethnicity among the study participants.

Results: One-thousand-eight-hundred-seventy-three women were enrolled in the study. There were 280 minority women and 328 women over the age of 70. Women age 70 and older had a 34% increase risk for death when compared to women under 60 (HR = 1.34; 95% CI 1.16-1.54). Non-Hispanic Black women had a 54% decreased risk of death with the addition of maintenance bevacizumab (HR = 0.46, 95% CI:0.26-0.83). Women of Asian descent had more hematologic grade 3 or greater adverse events and a 27% decrease risk of death when compared to non-Hispanic Whites (HR = 0.73; 95% CI: 0.59-0.90).

Conclusions: Non-Hispanic Black women showed a decreased risk of death with the addition of bevacizumab and patients of Asian ancestry had a lower death rate than all other minority groups, but despite these clinically meaningful improvements there was no statistically significant difference in OS among the groups.

Keywords: African American women; Asian women; Bevacizumab; Elderly; Minority populations; Ovarian cancer.

Publication types

  • Clinical Trial, Phase III
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / pathology
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Asian / statistics & numerical data
  • Bevacizumab / therapeutic use*
  • Black or African American / statistics & numerical data
  • Carboplatin / administration & dosage
  • Carcinoma, Endometrioid / drug therapy
  • Carcinoma, Endometrioid / pathology
  • Carcinoma, Ovarian Epithelial / drug therapy*
  • Carcinoma, Ovarian Epithelial / pathology
  • Chemotherapy, Adjuvant / methods*
  • Ethnicity / statistics & numerical data*
  • Fallopian Tube Neoplasms / drug therapy
  • Fallopian Tube Neoplasms / pathology
  • Female
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Middle Aged
  • Neoplasm Staging
  • Neoplasms, Cystic, Mucinous, and Serous / drug therapy*
  • Neoplasms, Cystic, Mucinous, and Serous / pathology
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / pathology
  • Paclitaxel / administration & dosage
  • Peritoneal Neoplasms / drug therapy
  • Peritoneal Neoplasms / pathology
  • Prognosis
  • Proportional Hazards Models
  • Survival Rate
  • White People / statistics & numerical data

Substances

  • Angiogenesis Inhibitors
  • Bevacizumab
  • Carboplatin
  • Paclitaxel