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
Pubmed link
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)