CHORUS Study

Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial

Disease site

Ovary

Publication month/year

May 2015

Study question

Is Neoadjuvant Chemotherapy (NACT) followed by Interval Debulking Surgery (IDS) non-inferior to Primary Debulking Surgery (PDS)

Type of study

Randomised controlled trial (RCT)

Interventions compared

NACT/IDS vs PDS

Experimental arm (Intervention)

PDS

Control arm

NACT/IDS (AUC5 or AUC6 Carboplatin plus Paclitaxel 175 mg/m2 every 3 weeks)

Primary outcome

Overall survival (OS)

Secondary outcome
  • Progression Free Survival (RFS)
  • QoL
Inclusion criteria
  • Women with clinically stage 3 or 4 ovarian cancer
  • Ca125/ CEA > 25
Exclusion criteria

Contraindication to PDS or NACT/IDS

Results
PDS NACT/IDS
Recruited(n) 274 276
Received treatment(n) 251 253
Stage 3C 175 (72%) 145 (71%)
Stage 4 41 (17%) 31 (15%)
Residual disease = 0 cm 39 (17%) 79 (39%)
Residual disease= 0-1 cm 57(24%) 68 (34%)
Residual disease > 1cm 137 (59%) 54 (27%)
Surgery time (min, median) All 12-450 (median=120) 30-330 (median=120)
OS(median, months) 22.6 24.1
PFS(median, months) 12 10.7
Grade 3/4 complications 24% 14%
Conclusions

NACT/IDS is non-inferior to PDS in advanced ovarian cancer

Study limitations

Extent and quality of surgical resection: 59% suboptimal debunking surgery in PDS time, median operating time only 120 min.

Additional resources

Metanalysis of CORUS & EORTC55971 (Link: https://pubmed.ncbi.nlm.nih.gov/30413383)

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