Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan.
Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan;
Anticancer Res. 2022 Sep;42(9):4603-4610. doi: 10.21873/anticanres.15964.
BACKGROUND/AIM: Ovarian cancer diagnosed with platinum-resistant recurrence has very poor prognosis and single-agent chemotherapy with no cross-resistance to prior chemotherapy is recommended for its treatment. In this study, we retrospectively evaluated the efficacy and safety of platinum rechallenge therapy for once diagnosed with platinum-resistant ovarian cancer who had a platinum-free interval (PFI) of at least 6 months.
The study included 49 patients who received platinum rechallenge therapy for ovarian, fallopian tube or primary peritoneal cancer who were once diagnosed with platinum-resistant recurrence between January 2010 and March 2021 and evaluated the efficacy and safety of this treatment. In addition, patient background factors were identified, and independent prognostic factors for progression-free survival (PFS) and overall survival (OS) were investigated.
A complete response was noted in 7 cases, partial response in 21, stable disease in 9, and progressive disease in 10. The response and disease control rates were 55% and 76%, respectively. The median PFS and OS were 8.5 months and 35.8 months, respectively. The independent prognostic factor was PFI for OS, and there was no independent prognostic factor for PFS. Seven patients discontinued chemotherapy owing to serious adverse events, including one patient with treatment-related death.
Platinum rechallenge therapy for patients with platinum-resistant recurrence did not cause previously unreported adverse events, and the adverse events were manageable. In addition, high response and disease control rates were observed, as well as long-term OS. Platinum rechallenge therapy for platinum-resistant ovarian cancer may be a viable treatment option.
背景/目的：铂耐药复发的卵巢癌预后极差，推荐使用无交叉耐药的单药化疗进行治疗。本研究回顾性评估了铂再挑战治疗对铂耐药卵巢癌患者的疗效和安全性，这些患者的铂无治疗间期（PFI）至少为 6 个月。
本研究纳入了 49 例曾诊断为铂耐药复发的卵巢癌、输卵管癌或原发性腹膜癌患者，这些患者于 2010 年 1 月至 2021 年 3 月期间接受了铂再挑战治疗，并评估了该治疗的疗效和安全性。此外，还确定了患者的背景因素，并研究了无进展生存期（PFS）和总生存期（OS）的独立预后因素。
7 例患者达到完全缓解，21 例患者达到部分缓解，9 例患者病情稳定，10 例患者病情进展。缓解率和疾病控制率分别为 55%和 76%。中位 PFS 和 OS 分别为 8.5 个月和 35.8 个月。OS 的独立预后因素是 PFI，而 PFS 无独立预后因素。7 例患者因严重不良事件停止化疗，包括 1 例与治疗相关的死亡。
铂再挑战治疗铂耐药复发患者未引起先前未报道的不良事件，且不良事件可管理。此外，观察到高缓解率和疾病控制率，以及长期 OS。铂再挑战治疗铂耐药卵巢癌可能是一种可行的治疗选择。
