title: Experience with trabectedin + pegylated liposomal doxorubicin for recurrent platinum-sensitive ovarian cancer unsuited to platinum rechallenge.
abstract: As most patients with ovarian cancer experience multiple remissions and relapses, oncologists must prepare ahead for long-term treatment. While platinum-based regimens are standard of care for platinum-sensitive recurrence, there are circumstances in which platinum rechallenge is not the best approach. These situations include patients with limited sensitivity to platinum; patients with residual toxicity from previous platinum therapy; and patients at risk of developing hypersensitivity reactions. An alternative regimen for these patients is the non-platinum combination of trabectedin + pegylated liposomal doxorubicin (PLD). Areas covered: In this review, case studies are presented to illustrate how careful strategic planning, in terms of therapeutic choices and optimal sequencing, can achieve good outcomes in difficult-to-treat patients. Expert commentary: Advantages with use of trabectedin + PLD in selected patients with platinum-sensitive recurrent ovarian cancer include additional time to recover from platinum-related toxicities, avoidance of hypersensitivity reactions, and the 'sequence effect' by which trabectedin may enhance response to next platinum and prolong survival.
authors: a European Institute of Oncology , University of Milan Bicocca , Milan , Italy.
authors: Nicoletta
authors: N
authors: Colombo
authors: b Centre CARIO-HPCA , Plérin , France.
authors: Anne-Claire
authors: AC
authors: Hardy-Bessard
authors: c Department of Medicine and Health Sciences , University of Molise, Campobasso/Gynecologic Oncology Unit, Fondazione 'Policlinico Universitario A. Gemelli' , Rome , Italy.
authors: Gabriella
authors: G
authors: Ferrandina
authors: d Department of Obstetrics and Gynecology , Medical University Innsbruck , Innsbruck , Austria.
authors: Christian
authors: C
authors: Marth
authors: e Clinical Area of Gynecological Cancer , Fundación Instituto Valenciano de Oncología , Valencia , Spain.
authors: Ignacio
authors: I
authors: Romero
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004149:Dioxoles / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives; D004342:Drug Hypersensitivity / Q000517:prevention & control; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017671:Platinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D011092:Polyethylene Glycols / Q000008:administration & dosage; D015996:Survival Rate; D044005:Tetrahydroisoquinolines / Q000008:administration & dosage; D000077606:Trabectedin; D016896:Treatment Outcome
chemical_list: D004149:Dioxoles; D017671:Platinum Compounds; D044005:Tetrahydroisoquinolines; C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D004317:Doxorubicin; D000077606:Trabectedin
keywords: Carboplatin; hypersensitivity; pegylated liposomal doxorubicin; platinum sensitive; recurrent ovarian cancer; sequence effect; trabectedin