European Institute of Oncology, University of Milan, Bicocca, Milan, Italy.
Future Oncol. 2013 Dec;9(12 Suppl):19-23. doi: 10.2217/fon.13.206.
Ovarian cancer is the leading cause of gynecological cancer deaths worldwide. Despite primary treatment with platinum-containing regimens, the majority of women will experience recurrent disease and subsequent death. Recurrent ovarian cancer remains a challenge for successful management, and the choice of second-line chemotherapy is complex due to the range of different factors that need to be considered. One of the main considerations is the platinum-free interval and, specifically, the optimal treatment for patients who are partially platinum-sensitive (platinum-free interval: 6-12 months). Data from the large, multicenter, randomized OVA-301 study have shown that combined trabectedin-pegylated liposomal doxorubicin (PLD) significantly prolonged median overall survival compared with PLD alone (p = 0.0027) in 214 patients with partially platinum-sensitive advanced relapsed ovarian cancer. Furthermore, in OVA-301 patients with partially platinum-sensitive disease who received platinum therapy immediately after disease progression (n = 94), final median overall survival was improved by 9 months (p = 0.0153) in trabectedin-PLD patients compared with PLD alone. In addition to demonstrating a survival advantage, trabectedin-PLD may also allow the treatment of patients having not yet recovered from previous platinum toxicity. In summary, the data suggest the use of combined trabectedin-PLD as a second-line treatment option in patients with partially platinum-sensitive recurrent ovarian cancer, followed by a third-line platinum-containing regimen.
卵巢癌是全球导致妇科癌症死亡的主要原因。尽管采用含铂方案进行了初始治疗,但大多数女性会出现疾病复发并随后死亡。复发性卵巢癌仍然是成功管理的挑战,由于需要考虑的因素范围广泛,二线化疗的选择较为复杂。其中一个主要考虑因素是铂类药物无治疗间隔期,特别是对于部分铂类敏感性(铂类药物无治疗间隔期:6-12 个月)患者的最佳治疗选择。来自大型多中心随机 OVA-301 研究的数据显示,与单独使用 PLD 相比,联合多柔比星脂质体注射用盐酸拓扑替康(trabectedin-PLD)在 214 例部分铂类敏感性晚期复发性卵巢癌患者中显著延长了中位总生存期(p=0.0027)。此外,在 OVA-301 中,94 例部分铂类敏感性疾病患者在疾病进展后立即接受铂类治疗,与单独使用 PLD 相比,trabectedin-PLD 患者的最终中位总生存期延长了 9 个月(p=0.0153)。trabectedin-PLD 不仅显示出生存优势,还可能允许治疗尚未从先前铂类毒性中恢复的患者。总之,这些数据表明,在部分铂类敏感性复发性卵巢癌患者中,应将联合 trabectedin-PLD 作为二线治疗选择,并随后使用三线含铂方案。
Future Oncol. 2013-12
Future Oncol. 2013-12
J Clin Oncol. 2010-6-1
Medicine (Baltimore). 2018-10