Background: Endocrine therapy is the standard-of-care maintenance treatment for estrogen receptor (ER)-positive breast cancers and is increasingly used in low-grade serous ovarian cancer. However, its therapeutic role in the early maintenance setting for ER-positive high-grade serous ovarian cancer (HGSC) remains undefined. Methods: A retrospective analysis was conducted on clinicopathological data from patients with newly diagnosed ER-positive HGSC following completion of adjuvant chemotherapy. Patients received maintenance therapy either with or without the aromatase inhibitor letrozole, in addition to standard maintenance care. ER expression levels and the administration of letrozole were analyzed, along with outcome measures for the entire cohort, with stratification based on residual disease status. Results: A total of 102 patients with newly diagnosed HGSC were included in the analysis, with 64 (62.7%) receiving letrozole and 38 (37.3%) not receiving letrozole. The median ER expression was 70%, with higher expression observed in the letrozole group compared to the no letrozole group (77.5% vs. 60%). No significant correlation was found between ER expression status and therapy response (p= 0.295 andp= 0.176, respectively). Letrozole therapy was well tolerated with no major adverse effects reported. In the overall cohort, maintenance letrozole therapy did not confer a significant improvement in progression-free survival (median 20.56 months vs. 29.34 months,p= 0.53) or overall survival (OS) (median 79.48 months vs. 46.85 months,p= 0.71) over a median follow-up duration of 23.5 months. However, among patients with no residual disease, maintenance letrozole therapy was associated with a statistically significant improvement in OS compared to those not receiving letrozole (median 114 months vs. 46.9 months,p= 0.006). Conclusions: Maintenance letrozole therapy appears to be a well-tolerated and potentially beneficial intervention in a subset of patients with ER-positive HGSC with no residual disease post-treatment. These findings highlight the need for further validation through prospective randomized trials to comprehensively assess the efficacy of endocrine therapy in this setting and its implications for patient quality of life.
背景：内分泌疗法是雌激素受体（ER）阳性乳腺癌的标准维持治疗方案，并越来越多地应用于低级别浆液性卵巢癌。然而，其在ER阳性高级别浆液性卵巢癌（HGSC）早期维持治疗中的作用尚未明确。方法：本研究对完成辅助化疗后新诊断的ER阳性HGSC患者的临床病理资料进行回顾性分析。患者在标准维持治疗基础上，接受含或不含芳香化酶抑制剂来曲唑的维持治疗。分析ER表达水平及来曲唑使用情况，并基于残留病灶状态分层评估全队列的预后指标。结果：共纳入102例新诊断HGSC患者，其中64例（62.7%）接受来曲唑治疗，38例（37.3%）未接受来曲唑治疗。ER表达中位水平为70%，来曲唑组ER表达水平高于非来曲唑组（77.5% vs. 60%）。ER表达状态与治疗反应无显著相关性（p值分别为0.295和0.176）。来曲唑治疗耐受性良好，未报告严重不良反应。在中位随访23.5个月期间，全队列中来曲唑维持治疗未显著改善无进展生存期（中位20.56个月 vs. 29.34个月，p=0.53）或总生存期（中位79.48个月 vs. 46.85个月，p=0.71）。但在无残留病灶患者亚组中，来曲唑维持治疗组总生存期较非来曲唑组显著延长（中位114个月 vs. 46.9个月，p=0.006）。结论：来曲唑维持治疗在治疗后无残留病灶的ER阳性HGSC患者亚群中表现出良好耐受性及潜在临床获益。这些发现提示需要通过前瞻性随机试验进一步验证，以全面评估内分泌疗法在此类患者中的疗效及其对生活质量的影响。
肿瘤(癌症)患者之家