Background: Second-line treatment of partially platinum-sensitive (6-12 months) recurrent ovarian cancer (ROC) is not so far standardized. Although preliminary results of phase III studies showed that the disease is still responsive to both platinum and non platinum-based regimens most of the patients eventually face progression. Extending the platinum-free interval (PFI) with non platinum therapies could increase the efficacy of a later platinum re-challenge in partially platinum-sensitive ROC. Methods: A retrospective analysis of 213 patients with 6-12 months ROC treated in 17 Italian centers between January 2003 and December 2006 was done through chart review. Response to 2nd line chemotherapy and overall survival (comparing platinum with non platinum-based regimens) were analyzed. Results: The median PFI was 8.7 months. At 2nd line, 95/199 patients (48%) received a platinum-based regimen (group A), and 104 (52%) a non platinum chemotherapy (group B). For 14 patients data were not available. Eighty-eight percent of patients in group A underwent multiple-drug chemotherapy (taxolcarboplatin 46%) whereas 75% of group B underwent single-agent chemotherapy (topotecan or PLD 56%). The complete plus partial response rates observed in group A and B were 74% and 33%, respectively (P< 0.01). In a multivariate Cox proportional hazard model which included age, PFI and type of recurrence (single vs. multiple) as covariates, the hazard ratio for death favored group A (HR= 0.52;95%CI= 0.35-0.80). Conclusions: Although retrospectively garnered, our data showed that the overall performance of current non-platinum regimes is low and that immediate platinum re- challenge remains the best option in partially platinum-sensitive ROC.
SECOND-LINE TREATMENT OF PARTIALLY-PLATINUM-SENSITIVE RECURRENT OVARIAN CANCER: A MANGO - PIEMONTE E VALLE D'AOSTA CANCER NETWORK ITALIAN MULTICENTRIC RETROSPECTIVE STUDY
FERRERO, Anna Maria;
2010-01-01
Abstract
Background: Second-line treatment of partially platinum-sensitive (6-12 months) recurrent ovarian cancer (ROC) is not so far standardized. Although preliminary results of phase III studies showed that the disease is still responsive to both platinum and non platinum-based regimens most of the patients eventually face progression. Extending the platinum-free interval (PFI) with non platinum therapies could increase the efficacy of a later platinum re-challenge in partially platinum-sensitive ROC. Methods: A retrospective analysis of 213 patients with 6-12 months ROC treated in 17 Italian centers between January 2003 and December 2006 was done through chart review. Response to 2nd line chemotherapy and overall survival (comparing platinum with non platinum-based regimens) were analyzed. Results: The median PFI was 8.7 months. At 2nd line, 95/199 patients (48%) received a platinum-based regimen (group A), and 104 (52%) a non platinum chemotherapy (group B). For 14 patients data were not available. Eighty-eight percent of patients in group A underwent multiple-drug chemotherapy (taxolcarboplatin 46%) whereas 75% of group B underwent single-agent chemotherapy (topotecan or PLD 56%). The complete plus partial response rates observed in group A and B were 74% and 33%, respectively (P< 0.01). In a multivariate Cox proportional hazard model which included age, PFI and type of recurrence (single vs. multiple) as covariates, the hazard ratio for death favored group A (HR= 0.52;95%CI= 0.35-0.80). Conclusions: Although retrospectively garnered, our data showed that the overall performance of current non-platinum regimes is low and that immediate platinum re- challenge remains the best option in partially platinum-sensitive ROC.
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