Valencia Institute of Oncology.
Diagonal Clinic.
Anticancer Drugs. 2019 Jul;30(6):628-635. doi: 10.1097/CAD.0000000000000794.
Debulking surgery, followed by taxane/platinum-based chemotherapy has traditionally been the first-line treatment for advanced ovarian cancer. However, most patients will experience recurrence afterwards, and receive subsequent lines of therapy. It has been proposed that extending the treatment-free interval of platinum can improve the response to a subsequent platinum-based chemotherapy, and reduce associated toxicities in women with recurrent, platinum-sensitive ovarian cancer. The aim was to determine the impact, in clinical practice, of trabectedin with pegylated liposomal doxorubicin (trabectedin/PLD) on the subsequent platinum-based therapy in these patients, and to explore the prognosis for breast cancer gene status and the expression of diverse genes. This was a multicenter, retrospective, postauthorization study that involved 79 patients. Germline or somatic mutations of breast cancer gene 1/2 were present in 21.5%. The median time between trabectedin/PLD and the onset of the subsequent treatment was 6.7 months. The overall response rate during the trabectedin/PLD period was 36.7%. In the subsequent first-line platinum-based therapy, the overall response rate was 51.4%. Progression-free survival and overall survival were 11.8 and 25.4 months, respectively, from the onset of trabectedin/PLD treatment. Partially platinum-sensitive (between 6 and 12 months) and platinum-sensitive patients (treatment-free interval of platinum≥12 months) showed no differences in progression-free survival and overall survival. Grade 3 neutropenia and asthenia were reported in 15.2 and 10.1% of patients, respectively. Most frequent adverse events in more than 10% of patients were neutropenia (45.6%), asthenia (43.0%), nausea (25.3%), and anemia (13.9%). The intercalation with a nonplatinum regimen may improve the response to a subsequent platinum-based therapy in women with recurrent, platinum-sensitive ovarian cancer.
减瘤手术联合紫杉烷/铂类化疗一直是晚期卵巢癌的一线治疗方法。然而，大多数患者随后会复发，并接受后续治疗。有人提出，延长铂类药物的无治疗间隔可以提高对后续铂类化疗的反应，并减少复发性铂类敏感卵巢癌女性的相关毒性。目的是确定在临床实践中，在这些患者中使用多柔比星脂质体结合曲贝替定（trabectedin/PLD）对随后的铂类药物治疗的影响，并探讨乳腺癌基因状态和不同基因表达的预后。这是一项多中心、回顾性、上市后研究，涉及 79 名患者。乳腺癌基因 1/2 的种系或体细胞突变存在于 21.5%的患者中。trabectedin/PLD 与随后治疗开始之间的中位时间为 6.7 个月。trabectedin/PLD 期间的总缓解率为 36.7%。在随后的一线铂类药物治疗中，总缓解率为 51.4%。从 trabectedin/PLD 治疗开始到无进展生存期和总生存期分别为 11.8 个月和 25.4 个月。部分铂类敏感（6-12 个月）和铂类敏感患者（铂类药物无治疗间隔≥12 个月）在无进展生存期和总生存期方面无差异。分别有 15.2%和 10.1%的患者报告出现 3 级中性粒细胞减少和乏力。超过 10%的患者中最常见的不良反应是中性粒细胞减少（45.6%）、乏力（43.0%）、恶心（25.3%）和贫血（13.9%）。与非铂类药物联合应用可能会改善复发性铂类敏感卵巢癌患者对后续铂类药物治疗的反应。
