title: Optimizing treatment of the partially platinum-sensitive ovarian cancer patient.
abstract: Ovarian cancer is the leading cause of gynecological cancer deaths worldwide. Despite primary treatment with platinum-containing regimens, the majority of women will experience recurrent disease and subsequent death. Recurrent ovarian cancer remains a challenge for successful management, and the choice of second-line chemotherapy is complex due to the range of different factors that need to be considered. One of the main considerations is the platinum-free interval and, specifically, the optimal treatment for patients who are partially platinum-sensitive (platinum-free interval: 6-12 months). Data from the large, multicenter, randomized OVA-301 study have shown that combined trabectedin-pegylated liposomal doxorubicin (PLD) significantly prolonged median overall survival compared with PLD alone (p = 0.0027) in 214 patients with partially platinum-sensitive advanced relapsed ovarian cancer. Furthermore, in OVA-301 patients with partially platinum-sensitive disease who received platinum therapy immediately after disease progression (n = 94), final median overall survival was improved by 9 months (p = 0.0153) in trabectedin-PLD patients compared with PLD alone. In addition to demonstrating a survival advantage, trabectedin-PLD may also allow the treatment of patients having not yet recovered from previous platinum toxicity. In summary, the data suggest the use of combined trabectedin-PLD as a second-line treatment option in patients with partially platinum-sensitive recurrent ovarian cancer, followed by a third-line platinum-containing regimen.
authors.affiliation: European Institute of Oncology, University of Milan, Bicocca, Milan, Italy. nicoletta.colombo@ieo.it.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Colombo
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017326:Clinical Trials, Phase III as Topic; D004149:Dioxoles / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality; D010984:Platinum / Q000008:administration & dosage / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000008:administration & dosage; D044005:Tetrahydroisoquinolines / Q000008:administration & dosage; D000077606:Trabectedin
chemical_list: D000970:Antineoplastic Agents; D004149:Dioxoles; D044005:Tetrahydroisoquinolines; C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D010984:Platinum; D004317:Doxorubicin; D000077606:Trabectedin