Laura Vertechy, Raffaella Ergasti, Cristina Chiamenti, Davide Arrigo, Ilary Ruscito, Alessandra Rizzi, Serena Maria Boccia, Carolina Maria Sassu, Giovanni Scambia, Anna Fagotti, Claudia Marchetti
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引用次数: 0
Abstract
Background: Prognosis for patients with early platinum-resistant Epithelial Ovarian Cancer (EOC) relapse after first-line chemotherapy remains poor. This study explores whether platinum rechallenge may be an option in this setting.
Methods: In this retrospective, single-institute, observational study, we enrolled BRCA1/2 wild-type (BRCAwt) patients who underwent surgery (January 2017-July 2021) and relapsed within 6 months after first-line platinum-based chemotherapy. Platinum (P) rechallenge was compared with pegylated liposomal doxorubicin (PLD) or non-platinum/non-PLD therapy (weekly paclitaxel/gemcitabine/topotecan, PGT). To minimize selection bias, propensity score matching (PSM) analysis was performed.
Results: Overall, 87 patients were identified: 18 (20.7%, P cohort), 50 (57.5%, PLD cohort) and 19 (21.8%, PGT cohort); after PSM, 54/87 patients were identified with similar characteristics, 18 for each group. Grade 3/4 toxicity events were more frequent in P group patients (13/18, 72.2%), compared to PDL (5/18, 27.8%) and PGT (7/18, 38.9%)(PvsPDL: p = 0.008; PvsPGT: p = 0.044; PDLvsPGT: p = 0.479; PvsPDLvsPGT: p = 0.021). Median progression-free survival (mPFS) was 9 months (P cohort) (CI 95%; 4.842-13.158), achieving a 4-month and 3-month increase compared to PLD (mPFS 5 months, p < 0.002) and PGT group (mPFS 6 months, p < 0.05), respectively. Median overall survival (mOS) benefit was preserved: 32 months (P cohort) compared to PLD (13 months, p = 0.001) and PGT (18 months, p = 0.01) groups. On multivariate analysis, platinum rechallenge was an independent prognostic factor for PFS (HR: 0.416; 95% CI: 0.215-0.807; p = 0.009) and OS (HR: 0.175; 95% CI: 0.061-0.503; p = 0.001). Results were consistent with the whole population.
Conclusions: Platinum rechallenge showed promising survival outcomes for BRCAwt patients recurring within 6 months after first-line platinum-based chemotherapy.
背景：一线化疗后早期铂耐药上皮性卵巢癌（EOC）复发患者的预后仍然很差。本研究探讨了在这种情况下铂金再挑战是否是一种选择。方法：在这项回顾性、单研究所观察性研究中，我们招募了接受手术（2017年1月至2021年7月）并在一线铂类化疗后6个月内复发的BRCA1/2野生型（brcat）患者。铂(P)再挑战与聚乙二醇化脂质体阿霉素（PLD）或非铂/非PLD治疗（每周一次紫杉醇/吉西他滨/拓扑替康，PGT）进行比较。为了尽量减少选择偏差，进行倾向得分匹配（PSM）分析。结果：共发现87例患者：18例（20.7%，P队列），50例（57.5%，PLD队列）和19例（21.8%，PGT队列）；经PSM后，87例患者中有54例具有相似特征，每组18例。P组患者3/4级毒性事件发生率（13/18,72.2%）高于PDL组（5/18,27.8%）和PGT组（7/18,38.9%）(PvsPDL: P = 0.008；PvsPGT: p = 0.044；PDLvsPGT: p = 0.479；PvsPDLvsPGT: p = 0.021)。中位无进展生存期（mPFS）为9个月（P队列）(CI 95%；（4.842-13.158），与PLD相比，mPFS分别增加了4个月和3个月（mPFS为5个月）。结论：铂再挑战对于一线铂基化疗后6个月内复发的BRCAwt患者显示出有希望的生存结果。
期刊介绍：
The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.
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