Dragomir Radu-Dumitru, Mercioni Marina Adriana, Negru Șerban, Popovici Dorel, Săftescu Sorin, Blidari Andiana Roxana, Sas Ioan
Department of Obstetrics and Gynecology, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timișoara, Romania.
Faculty of Electronics, Telecommunications and Information Technologies, Politehnica University, 300223 Timișoara, Romania.
J Pers Med. 2025 Jan 19;15(1):39. doi: 10.3390/jpm15010039.
: Platinum-resistant ovarian cancer (PROC) is a major therapeutic challenge, as it responds poorly to standard platinum-based treatment, has limited treatment options, and offers a generally unfavorable prognosis. Chemotherapeutic agents like pegylated liposomal doxorubicin (PLD), topotecan (TOPO), and gemcitabine (GEM) are used for this setting, but with varying efficacy and toxicity profiles, leading to an increasing need to understand the optimal balance between treatment effectiveness and tolerability for improving patient outcomes. This study evaluates the efficacy and side effects of PLD, TOPO, and GEM, focusing on progression-free survival (PFS), overall survival (OS), and safety profiles. : We conducted a retrospective observational study that included 856 PROC patients treated with PLD ( = 383), TOPO ( = 352), or GEM ( = 121) at the OncoHelp Oncology Center from January 2018 to December 2023. Inclusion criteria encompass diagnosis, prior platinum therapy, and Eastern Cooperative Oncology Group (ECOG) status (0-2). Treatment protocols followed standard dosing, with adjustments for toxicity. Primary endpoints included PFS and OS, with safety assessed by incidence of grade 3 and 4 toxicities per CTCAE v5.0. Kaplan-Meier analysis and Cox regression were used to compare survival, and statistical significance was set at < 0.05. : TOPO showed higher toxicity than PLD and GEM, including liver damage, hematological and non-hematological side effects, while PLD induced more skin toxicity. In terms of survival, minor differences were seen between the three chemotherapeutic agents, with a slight advantage for PLD for better disease control. : Given the comparable results in OS across the regimens, treatment decisions should be based on other factors such as patient tolerance and quality of life.
铂耐药卵巢癌（PROC）是一个重大的治疗挑战，因为它对标准铂类治疗反应不佳，治疗选择有限，且总体预后不佳。聚乙二醇化脂质体阿霉素（PLD）、拓扑替康（TOPO）和吉西他滨（GEM）等化疗药物用于这种情况，但疗效和毒性特征各不相同，因此越来越需要了解治疗效果和耐受性之间的最佳平衡以改善患者预后。本研究评估了PLD、TOPO和GEM的疗效和副作用，重点关注无进展生存期（PFS）、总生存期（OS）和安全性。我们进行了一项回顾性观察研究，纳入了2018年1月至2023年12月期间在OncoHelp肿瘤中心接受PLD（n = 383）、TOPO（n = 352）或GEM（n = 121）治疗的856例PROC患者。纳入标准包括诊断、既往铂类治疗以及东部肿瘤协作组（ECOG）状态（0 - 2）。治疗方案遵循标准剂量，并根据毒性进行调整。主要终点包括PFS和OS，安全性通过根据CTCAE v5.0评估的3级和4级毒性发生率来评估。采用Kaplan - Meier分析和Cox回归比较生存率，统计学显著性设定为P < 0.05。TOPO显示出比PLD和GEM更高的毒性，包括肝损伤、血液学和非血液学副作用，而PLD诱导更多的皮肤毒性。在生存方面，三种化疗药物之间存在微小差异，PLD在更好地控制疾病方面略有优势。鉴于各治疗方案在OS方面的结果相当，治疗决策应基于其他因素，如患者耐受性和生活质量。
