title: Prognostic factors associated with response in platinum retreatment of platinum-resistant ovarian cancer.
abstract: The goal of this study was to determine the factors associated with response to platinum retreatment in patients with platinum-resistant ovarian cancer. A review of patients with epithelial ovarian cancer retreated with cisplatin or carboplatin between 2002 and 2004 was performed. The platinum-free interval (PFI) and treatment-free interval (TFI) were determined for each patient. Response was based on serial CA125 levels using a modification of the Rustin criteria. Patients with clinical benefit ([CB] those who attained at least stable disease) were compared to patients with disease progression (PD). An analysis was performed to determine factors associated with CB in platinum-resistant patients retreated with platinum. Of 48 patients identified, 37 were evaluable included in this analysis. CB was observed in 27 (73%) while disease progression was noted in 10 (27%) women. The PFI was longer in those women who achieved CB (12.3 vs 6.9 months; P = 0.02). The TFI was 7.1 months for patients benefited from platinum retreatment vs 3.5 months for those with disease progression (P = 0.06). There was no statistically significant difference in the number of cytotoxic agents between the time of platinum retreatment and the prior platinum regimen (2 vs 1.5 months; P = 0.61). A prolonged PFI was associated with an improved chance of achieving CB with platinum retreatment. There was no association between the response to platinum retreatment and the number of intervening cytotoxic agents utilized. Further prospective study is warranted to define the optimal timing of platinum retreatment.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: T T
authors.initials: TT
authors.lastname: Nguyen
authors.forename: J D
authors.initials: JD
authors.lastname: Wright
authors.forename: M A
authors.initials: MA
authors.lastname: Powell
authors.forename: R K
authors.initials: RK
authors.lastname: Gibb
authors.forename: J S
authors.initials: JS
authors.lastname: Rader
authors.forename: J E
authors.initials: JE
authors.lastname: Allsworth
authors.forename: D G
authors.initials: DG
authors.lastname: Mutch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D019008:Drug Resistance, Neoplasm / Q000187:drug effects*; D005260:Female; D006801:Humans; D047908:Intracellular Signaling Peptides and Proteins; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology*; D017671:Platinum Compounds / Q000627:therapeutic use*; D011379:Prognosis; D011506:Proteins / Q000378:metabolism; D016879:Salvage Therapy; D017211:Treatment Failure
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D047908:Intracellular Signaling Peptides and Proteins; C549756:NBR1 protein, human; D017671:Platinum Compounds; D011506:Proteins