Consolidation or maintenance systemic therapy for newly diagnosed stage II, III, or IV epithelial ovary, fallopian tube, or primary peritoneal carcinoma: A systematic review

Hal Hirte; Xiaomei Yao; Sarah E Ferguson; Taymaa May; Laurie Elit

doi:10.1016/j.critrevonc.2021.103336

Consolidation or maintenance systemic therapy for newly diagnosed stage II, III, or IV epithelial ovary, fallopian tube, or primary peritoneal carcinoma: A systematic review

Crit Rev Oncol Hematol. 2021 Jun:162:103336. doi: 10.1016/j.critrevonc.2021.103336. Epub 2021 Apr 16.

Authors

Hal Hirte¹, Xiaomei Yao², Sarah E Ferguson³, Taymaa May⁴, Laurie Elit⁵

Affiliations

¹ Department of Oncology, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. Electronic address: hirteh@hhsc.ca.
² Department of Oncology, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Program in Evidence-Based Care, Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada. Electronic address: yaoxia@mcmaster.ca.
³ Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; Division of Gynecologic Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada. Electronic address: Sarah.Ferguson@uhn.ca.
⁴ Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; Division of Gynecologic Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada. Electronic address: Taymaa.May@uhn.ca.
⁵ Department of Oncology, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada. Electronic address: elitlor@hhsc.ca.

PMID: 33865996
DOI: 10.1016/j.critrevonc.2021.103336

Abstract

Backgrounds: To systematically review the effectiveness and harm of consolidation or maintenance therapy in patients with newly diagnosed stage II-IV EOC.

Methods: MEDLINE, EMBASE, PubMed, Cochrane Library, and PROSPERO databases, and four relevant conferences were systematically searched. We adhered to PRISMA guidelines, and used the GRADE approach to aggregate data.

Results: Among 12,675 citations, 28 comprising 16,310 patients were analyzed. The certainty of aggregated study evidence ranged from high to low.

Conclusions: The existing evidence does not find overall survival benefit for consolidation therapy with chemotherapy. For maintenance therapy, comparing with placebo, olaparib, niraparib, veliparib, and bevacizumab are effective as maintenance therapy for certain patients with newly diagnosed stage III-IV epithelial ovarian, fallopian tube, or primary peritoneal carcinoma respectively without reducing quality of life. Longer follow-up with more mature results of overall survival will better define the effect of these agents.

Keywords: Chemotherapy; Consolidation therapy; First-line therapy; Maintenance therapy; Ovarian cancer.

Publication types

Review
Systematic Review

MeSH terms

Carcinoma*
Fallopian Tube Neoplasms* / diagnosis
Fallopian Tube Neoplasms* / drug therapy
Fallopian Tubes
Female
Humans
Ovarian Neoplasms* / diagnosis
Ovarian Neoplasms* / drug therapy
Quality of Life