Nefertiti C duPont1, Danielle Enserro2, Mark F Brady3, Katherine Moxley4, Joan L Walker5, Casey Cosgrove6, Kristin Bixel7, Krishnansu S Tewari8, Premal Thaker9, Andrea E Wahner Hendrickson10, Stephen Rubin11, Keiichi Fujiwara12, A Catherine Casey13, John Soper14, Robert A Burger15, Bradley J Monk16. 1. North Houston Gynecologic Oncology Surgeons, Shenandoah, TX, USA. Electronic address: ndupont@gynonchouston.com. 2. NRG Oncology, Clinical Trial Development Division, Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA. Electronic address: enserrod@nrgoncology.org. 3. NRG Oncology, Clinical Trial Development Division, Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA. Electronic address: bradym@nrgoncology.org. 4. University of Oklahoma, Oklahoma University Hospital Science Center, Oklahoma City, OK 73104, USA. Electronic address: Katherine-moxley@ouhsc.edu. 5. University of Oklahoma, Oklahoma University Hospital Science Center, Oklahoma City, OK 73104, USA. Electronic address: Joan-walker@ouhsc.edu. 6. Ohio State University Medical Center, USA. Electronic address: Casey.cosgrove@osumc.edu. 7. Ohio State University Medical Center, USA. Electronic address: Kristin.Bixel@osumc.edu. 8. University of California at Irvine, Orange, CA 92868, USA. Electronic address: ktewari@uci.edu. 9. Washington University, Saint Louis, MO 63110, USA. Electronic address: thakerp@wustl.edu. 10. Mayo Clinic, Rochester, MN 55905, USA. Electronic address: WahnerHendrickson.Andrea@mayo.edu. 11. Abramson Cancer Center at University of Pennsylvania, Philadelphia, PA 19111, USA. Electronic address: Stephen.rubin@fccc.edu. 12. Saitama Medical University/International Medical Center, Saitama, JP 350-1298, Japan. Electronic address: fujiwara@saitama-med.ac.jp. 13. Metro Minn CCOP, Minneapolis, MN, USA. Electronic address: acatherine.casey@usoncology.com. 14. University of North Carolina, Chapel Hill, NC 27599, USA. Electronic address: john_soper@med.unc.edu. 15. Division of Gynecologic Oncology, Arizona Oncology (US Oncology Network), Phoenix, AZ, USA. Electronic address: Bob@xonehorse.com. 16. University of Arizona College of Medicine, Phoenix Creighton University School of Medicine at St. Joseph's Hospital, Phoenix, AZ, USA. Electronic address: Bradley.Monk@usoncology.com.
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.
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.
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