Expert Point of View: ­Jonathan S. Berek, MD


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Weekly vs every-3-week therapy is a somewhat controversial area in ovarian cancer, said formal discussant of the MITO-7 trial, ­Jonathan S. Berek, MD, Director of the Stanford Women’s Cancer Center, Palo Alto, California.

“[Japan Clinical Oncology Group (JCOG)]-16 showed a survival advantage for both progression-free and overall survival for dose-dense chemotherapy, and another study—[Gynecologic Oncology Group (GOG)] 262—is looking at this question along with bevacizumab [Avastin]. MITO-7 seems to trend toward improved survival with the weekly schedule, but a fairly high proportion of patients with low-stage disease were included in this trial, and dose-dense chemotherapy may be more relevant for more advanced-stage patients,” Dr. Berek told listeners.

Better Therapeutic Index

Quality of life was significantly better in the weekly arm (P < .0001) in MITO-7. “This shows the importance of giving therapy at the right time, because the toxicity was lower and [quality of life] was better, leading to a better therapeutic index. The results support the weekly schedule as part of practice,” Dr. Berek stated.

“We await data from other trials. Several studies are maturing within 1 to 5 years, and will help us answer the question,” he said.

Dr. Berek applauded the quality-of-life analysis of MITO-7. “It is critical to continue to analyze [quality of life] in all these trials. The choice of therapy may come down to what patients can tolerate better,” he commented. ■

Disclosure: Dr. Berek reported no potential conflicts of interest.


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