190 Selecting patients for 3rd line chemotherapy and beyond in epithelial ovarian cancer

Background Many epithelial ovarian cancer (EOC) patients had disease progression during 3rd line chemotherapy and beyond. This study aimed to select these patients and avoid unnecessary chemotherapy. Materials and Methods We retrospectively analysed 274 EOC patients who had treated with 2nd to 5th chemotherapy. Progression-free survival (PFS) and disease control rate (DCR), and prognostic factors for each line were analysed. Result The median PFS was shorter as the line of chemotherapy increased (median PFS of 2nd regimen, 9.0 months, vs. median PFS of 3rd regimen, 6.1 month, vs. median PFS of 4th regimen, 3.9 months, vs. median PFS of 5th regimen, 3.4 months). The DCR was lower as the line of chemotherapy increased (DCR of 2nd regimen, 66.7% vs. DCR of 3rd regimen, 48.2% vs. DCR of 4th regimen, 31.3%, vs. DCR of 5th regimen, 20%). Platinum-sensitive EOC patients were significantly effective with 3rd, 4th, or 5th line chemotherapy (p=0.006). 3rd or more line chemotherapy was effective in patients with treatment free interval (TFI) over 3 months in previous chemotherapy (p=0.014). CA-125 at recurrence over 200 was statistically related to poor prognosis (p=0.002). Endometrioid cell type had significantly better outcomes than other cell type (p=0.01). Other factors were not significantly different Conclusion EOC patients with platinum resistance, elevated CA-125 at recurrence, short TFI at previous regimen, and non-endometrioid cell type were associated with progression disease after 3rd line chemotherapy or beyond. Discontinuation of 3rd line chemotherapy and beyond should be carefully considered when EOC patients have the factors above mentioned.