Colombo Nicoletta, Hardy-Bessard Anne-Claire, Ferrandina Gabriella, Marth Christian, Romero Ignacio
a European Institute of Oncology , University of Milan Bicocca , Milan , Italy.
b Centre CARIO-HPCA , Plérin , France.
Expert Rev Anticancer Ther. 2016 Nov;16(sup1):11-19. doi: 10.1080/14737140.2016.1243475.
As most patients with ovarian cancer experience multiple remissions and relapses, oncologists must prepare ahead for long-term treatment. While platinum-based regimens are standard of care for platinum-sensitive recurrence, there are circumstances in which platinum rechallenge is not the best approach. These situations include patients with limited sensitivity to platinum; patients with residual toxicity from previous platinum therapy; and patients at risk of developing hypersensitivity reactions. An alternative regimen for these patients is the non-platinum combination of trabectedin + pegylated liposomal doxorubicin (PLD). Areas covered: In this review, case studies are presented to illustrate how careful strategic planning, in terms of therapeutic choices and optimal sequencing, can achieve good outcomes in difficult-to-treat patients. Expert commentary: Advantages with use of trabectedin + PLD in selected patients with platinum-sensitive recurrent ovarian cancer include additional time to recover from platinum-related toxicities, avoidance of hypersensitivity reactions, and the 'sequence effect' by which trabectedin may enhance response to next platinum and prolong survival.
由于大多数卵巢癌患者会经历多次缓解和复发，肿瘤学家必须提前为长期治疗做好准备。虽然铂类方案是铂敏感复发患者的标准治疗方法，但在某些情况下，再次使用铂类并非最佳方法。这些情况包括对铂敏感性有限的患者；既往铂类治疗有残留毒性的患者；以及有发生超敏反应风险的患者。对于这些患者，一种替代方案是曲贝替定+聚乙二醇化脂质体阿霉素（PLD）的非铂类联合方案。涵盖领域：在本综述中，通过案例研究来说明在治疗选择和最佳序贯方面进行仔细的战略规划如何能在难治性患者中取得良好疗效。专家评论：在铂敏感复发性卵巢癌的特定患者中使用曲贝替定+PLD的优势包括从铂相关毒性中恢复的额外时间、避免超敏反应，以及曲贝替定可能增强对下一剂铂类的反应并延长生存期的“序贯效应”。
