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Gynecol Oncol. 2014 Jun;133(3):624-31. doi: 10.1016/j.ygyno.2014.02.038. Epub 2014 Mar 4.

"Platinum resistant" ovarian cancer: what is it, who to treat and how to measure benefit?

Author information

1
The Canberra Hospital and The Australian National University, Canberra, Australia. Electronic address: Alison.davis@act.gov.au.
2
Vancouver Centre, British Columbia Cancer Agency, Vancouver, Canada.
3
The Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.

Abstract

"Platinum resistant" ovarian cancer was historically defined as disease recurrence within 6months of completion of first-line platinum-based chemotherapy, although this is now more broadly applied to also include patients progressing within 6months after multiple lines of chemotherapy. However, this definition ignores the heterogeneity and complexity of the spectrum of diseases that comprise "platinum resistant ovarian cancer" (PROC) and is innately flawed as it was initially derived using methods of detection of recurrence that would now be regarded as outdated. The outcome of patients with PROC is generally poor, with low response rates to further chemotherapy and a median survival of less than 12months, but this is unpredictable and can be quite variable from study to study. This review outlines the complexity of PROC, examines how this impacts on the interpretation of the results of clinical trials, and explores how the definition may be improved. We also briefly describe the mechanisms of platinum resistance, the results of clinical trials to date as well as treatment options for patients with PROC and highlight the need for better methods of assessing clinical benefit in this poor prognostic sub group of patients.

KEYWORDS:

Genotype; Histotype; Ovarian cancer; Platinum resistant; Treatment

PMID:
24607285
DOI:
10.1016/j.ygyno.2014.02.038
[Indexed for MEDLINE]

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