The finding that women who received early chemotherapy for a recurrence of ovarian cancer did not live longer than those whose treatment is delayed needs to be reviewed, says an expert.
The study was published in The Lancet last month.
Now, Bradley Monk, gynaecologic oncologist at St. Joseph's Hospital and Medical Centre in Phoenix, Arizona has warned that the results of the long-awaited global study of ovarian cancer should be viewed cautiously.
"While this study is a bold challenge to the assumption of early treatment, there are several significant problems with the findings," Monk said in an editorial in The Lancet.
"Our focus should no longer be on standard chemotherapy, but on targeted genetics-based treatments," he said.
He and Robert Morris of Wayne State University wrote that finding the relevant therapy is far more important than timing when treating ovarian cancer.
"The most troubling problem with the trial is that contemporary therapies were not available to most of the participants.
"This lack of availability is related not only to the chronological length of the trial (which started in 1996), but also to regulatory and financial barriers restricting access to all active compounds in the participating countries," said Monk.
In the study, survival rates were not significantly different between those who started chemotherapy once a higher concentration of cancer-related proteins were detected and those whose treatment was delayed until they had clinical symptoms.
A total of 1,442 women from 59 centres around the world registered for the trial, and 529 were randomly assigned to treatment groups. About 70 percent of the women died.
Of the 370 deaths, 186 occurred in the early treatment group and 184 in the delayed treatment. Median survival was 25.7 months for those on early treatment and 27.1 months for those on delayed treatment.