铂耐药卵巢癌患者再次接受铂基化疗：一项队列研究

IF 4.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Gynecologic oncology Pub Date : 2025-02-08 DOI:10.1016/j.ygyno.2025.01.014

Carmine Valenza , Marta Mongillo , Maria Vittoria Visconti , Jalissa Katrini , Dario Trapani , Laura Boldrini , Lorenzo Guidi , Alessia Farfalla , Daniela Malengo , Giuseppe Caruso , Silvia Derio , Mariateresa Lapresa , Gabriella Parma , Elena Biagioli , Emanuela Omodeo Salé , Giuseppe Curigliano , Nicoletta Colombo

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引用次数: 0

摘要

根据2018年ESMO-ESGO共识会议关于卵巢癌的建议，如果铂耐药疾病患者在之前的铂治疗期间没有进展，则可以考虑在接受非铂方案治疗后进行铂再挑战。然而，在这种特殊情况下，特别是在目前卵巢癌治疗算法中纳入新药物后，很少有数据可用。方法：2010年1月至2024年6月，我们在欧洲肿瘤研究所（意大利）进行了一项单中心、回顾性、队列研究，以评估铂再挑战在铂耐药疾病中至少一种非铂治疗方案进展的高级别卵巢癌患者中的活性。30例患者的样本量允许估计6个月无进展生存率（PFS）为30%，95%置信区间（CI）为14%至47%。结果共纳入30例患者：23例（77%）接受卡铂治疗，7例（23%）接受顺铂治疗。先前治疗线的中位数为3（四分位数范围：3 - 4）。客观有效率为27% (95% CI: 12 ~ 46%)，疾病控制率为80% （95% CI: 61 ~ 92）。中位随访14.1个月（范围：3.3-52.7）后，中位PFS为5.4个月（95% CI: 2.5-8.2）， 6个月PFS率为47% （95% CI: 28 - 63%）。结论铂再挑战治疗对于之前接受过非铂治疗方案的铂耐药卵巢癌患者是一种可行的治疗选择。这项研究表明，我们可以动态地重新评估铂是否是患者治疗史上的最佳选择。

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Rechallenge with platinum-based chemotherapy in patients with platinum-resistant ovarian carcinoma: A cohort study

Background

According to the 2018 ESMO-ESGO consensus conference recommendations on ovarian cancer, platinum rechallenge could be considered in patients with platinum-resistant disease following a treatment with a non‑platinum regimen, if they had not progressed during prior platinum therapy. However, few data are available in this specific setting, especially after the incorporation of novel agents in the current treatment algorithm for ovarian cancer.

Methods

We conducted a single-center, retrospective, cohort study to evaluate the activity of platinum rechallenge in patients with high-grade ovarian cancer, progressing on at least one non‑platinum regimen for platinum-resistant disease, from January 2010 to June 2024, at the European Institute of Oncology (Italy). A sample size of 30 patients allowed to estimate a 6-month progression-free survival (PFS) rate of 30 %, with a 95 % confidence interval (CI) ranging from 14 % to 47 %.

Results

30 patients were included: 23 (77 %) received rechallenge with carboplatin and 7 (23 %) with cisplatin. The median number of previous treatment lines was 3 (interquartile range: 3–4). The objective response rate was 27 % (95 % CI: 12–46 %) and the disease control rate was 80 % (95 % CI: 61–92). After a median follow-up of 14.1 months (range: 3.3–52.7), the median PFS was 5.4 months (95 % CI: 2.5–8.2) and the 6-month PFS rate was 47 % (95 % CI: 28–63 %).

Conclusions

Platinum rechallenge can be a viable treatment option for selected patients with platinum-resistant ovarian cancer who have previously received a non‑platinum regimen. This study suggests that we could dynamically reassess whether platinum is the best option during the patient's treatment history.

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来源期刊

Gynecologic oncology 医学-妇产科学

CiteScore

8.60

自引率

6.40%

发文量

1062

审稿时长

37 days

期刊介绍： Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy