title: Survival outcomes in patients with recurrent ovarian cancer who were treated with chemoresistance assay-guided chemotherapy.
abstract: OBJECTIVE
  The purpose of this study was to determine the outcome of patients with recurrent ovarian carcinoma after extreme drug resistance assay-directed therapy.
  
  
  METHODS
  Fifty women who were treated with chemotherapy based on extreme drug resistance assay guidance were compared with 50 well-balanced control subjects who were treated empirically.
  
  
  RESULTS
  In the platinum-sensitive group, patients with extreme drug resistance-directed therapy had an overall response rate of 65% compared with 35% in the patients who were treated empirically (P=.02). The overall and progression-free median survival were 38 and 15 months in the extreme drug resistance assay group compared with 21 and 7 months in the control group, respectively (P=.005, overall; P=.0002, progression free). In the platinum-resistant group, there was no improved outcome in the patients who underwent assay-guided therapy. In multivariate analysis, platinum-sensitive disease, extreme drug resistance-guided therapy and early stage of disease were independent predictors for improved survival.
  
  
  CONCLUSIONS
  In this retrospective analysis, our results indicate an improved outcome in patients with recurrent ovarian carcinoma who have platinum sensitive disease and who underwent extreme drug resistance-directed chemotherapy. Randomized, prospective, controlled trials are needed.
authors.affiliation: Division of Gynecologic Oncology, Chao Family Comprehensive Cancer Center, University of California-Irvine Medical Center, 101 The City Drive, Orange, CA 92868, USA.
authors.forename: Vera
authors.initials: V
authors.lastname: Loizzi
authors.forename: John K
authors.initials: JK
authors.lastname: Chan
authors.forename: Kathryn
authors.initials: K
authors.lastname: Osann
authors.forename: Fabio
authors.initials: F
authors.lastname: Cappuccini
authors.forename: Philip J
authors.initials: PJ
authors.lastname: DiSaia
authors.forename: Michael L
authors.initials: ML
authors.lastname: Berman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000503:physiopathology*; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000503:physiopathology*; D010984:Platinum / Q000627:therapeutic use; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D010984:Platinum