a Department of Obstetrics and Gynecology , Medical University of Innsbruck , Innsbruck , Austria.
Expert Rev Anticancer Ther. 2018 Oct;18(sup1):19-22. doi: 10.1080/14737140.2018.1513793.
The challenges of managing relapsed ovarian cancer increase as more advanced lines of chemotherapy are achieved.
A case study is presented to illustrate the complexities of selecting treatment in a patient with platinum-sensitive relapsed ovarian cancer and exposure to two previous lines of platinum-based chemotherapy.
In this clinical scenario, options include re-treatment with platinum-based chemotherapy or treatment with a nonplatinum single-agent or a nonplatinum combination. In this case, the nonplatinum combination of trabectedin + pegylated liposomal doxorubicin (PLD) was selected as the patient had limited platinum sensitivity (progression-free interval of 9 months), no BRCA mutation, and taking into account evidence that the regimen is effective and safe in the third line and beyond and may restore platinum sensitivity. After nine cycles of trabectedin + PLD, there was no evidence of disease. The patient was able to resume normal activities during therapy. Progression-free interval (PFI) was 17 months before disease progression. Subsequent platinum rechallenge produced a partial response.
Trabectedin + PLD may be an option for patients with platinum-sensitive relapsed ovarian cancer, including those who have received two or more previous lines of platinum.
随着更多的化疗方案进入晚期，管理复发性卵巢癌的挑战不断增加。
本文通过病例研究，阐述了一名铂类药物敏感复发卵巢癌患者在经历两种铂类药物化疗后，选择治疗方案的复杂性。
在这种临床情况下，可选择的方案包括铂类药物化疗的再治疗，或使用非铂类单药或非铂类联合治疗。在本例中，选择了非铂类联合治疗方案，即多柔比星脂质体注射液（PLD）联合 trabectedin，因为患者铂类药物敏感性有限（无进展生存期为 9 个月），无 BRCA 突变，并且考虑到该方案在三线及以上治疗中有效且安全，并可能恢复铂类药物敏感性。在接受 trabectedin+PLD 治疗 9 个周期后，疾病无进展。患者在治疗期间能够恢复正常活动。疾病无进展时间（PFI）为 17 个月，随后铂类药物再挑战产生部分缓解。
trabectedin+PLD 可能是铂类药物敏感复发性卵巢癌患者的一种选择，包括那些已经接受过两种或两种以上铂类药物治疗的患者。
