The Canberra Hospital and The Australian National University, Canberra, Australia.
Vancouver Centre, British Columbia Cancer Agency, Vancouver, Canada.
Gynecol Oncol. 2014 Jun;133(3):624-31. doi: 10.1016/j.ygyno.2014.02.038. Epub 2014 Mar 4.
"Platinum resistant" ovarian cancer was historically defined as disease recurrence within 6months of completion of first-line platinum-based chemotherapy, although this is now more broadly applied to also include patients progressing within 6months after multiple lines of chemotherapy. However, this definition ignores the heterogeneity and complexity of the spectrum of diseases that comprise "platinum resistant ovarian cancer" (PROC) and is innately flawed as it was initially derived using methods of detection of recurrence that would now be regarded as outdated. The outcome of patients with PROC is generally poor, with low response rates to further chemotherapy and a median survival of less than 12months, but this is unpredictable and can be quite variable from study to study. This review outlines the complexity of PROC, examines how this impacts on the interpretation of the results of clinical trials, and explores how the definition may be improved. We also briefly describe the mechanisms of platinum resistance, the results of clinical trials to date as well as treatment options for patients with PROC and highlight the need for better methods of assessing clinical benefit in this poor prognostic sub group of patients.
“铂耐药”卵巢癌的定义在历史上为一线含铂化疗结束后 6 个月内疾病复发，尽管现在更广泛地应用于也包括在多线化疗后 6 个月内进展的患者。然而，该定义忽略了构成“铂耐药卵巢癌”（PROC）的疾病谱的异质性和复杂性，并且由于最初使用的复发检测方法现在被认为已经过时，因此从根本上存在缺陷。PROC 患者的预后通常较差，对进一步化疗的反应率低，中位生存期不到 12 个月，但这是不可预测的，而且在不同的研究中可能差异很大。本综述概述了 PROC 的复杂性，检查了这如何影响临床试验结果的解释，并探讨了如何改进该定义。我们还简要描述了铂耐药的机制、迄今为止的临床试验结果以及 PROC 患者的治疗选择，并强调需要更好的方法来评估这一预后较差的亚组患者的临床获益。
