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Cancer Chemother Pharmacol. 2019 Apr 13. doi: 10.1007/s00280-019-03834-1. [Epub ahead of print]

Platinum-free interval affects efficacy of following treatment for platinum-refractory or -resistant ovarian cancer.

Author information

1
Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan.
2
Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan. mayu.yunokawa@jfcr.or.jp.
3
Department of Medical Oncology/Gynecologic Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan. mayu.yunokawa@jfcr.or.jp.
4
Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan.
5
Department of Perinatal and Women'S Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
6
Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.

Abstract

BACKGROUND/OBJECTIVE:

Platinum-refractory or -resistant ovarian cancer (PRROC) is associated with poor prognosis and low response to further chemotherapy. We investigated predictors of effectiveness of following treatments for PRROC.

PATIENTS AND METHODS:

We included 380 patients diagnosed with stage I-IV ovarian, fallopian tube, or primary peritoneal cancer, who were treated at the National Cancer Center Hospital in Japan from January 2007 to December 2014 and recurred after initial treatment, who had a platinum-refractory or -resistant relapses and received chemotherapy, in this single-center, retrospective study. We investigated factors related to response to following treatment, and to progression-free survival (PFS).

RESULTS:

Among 183 patients (48%) who suffered recurrences, 62 (34%) developed PRROC after chemotherapy. In multivariate analysis, platinum-free interval (PFI) < 3 months was independently associated with progressive disease (odds ratio [OR] 6.043, 95% confidence interval [CI] 1.485-24.595, P = 0.012). Median PFS was 139 days (95% CI 19.4-258) among patients with PFI > 3 months, but was 57 days (95% CI 34.7-79.2) among those with PFI < 3 months. In multivariate analysis, two factors, performance status (PS) 1-2 (HR 1.915, 95% CI 1.074-3.415, P = 0.028) and PFI < 3 months (HR 1.943, 95% CI 1.109-3.403, P = 0.02), were independently associated with worse PFS.

CONCLUSIONS:

PS 1-2 and PFI < 3 months were significant predictors of poor response to following treatment for PRROC. Risks and benefits of treatment should be frankly discussed with patients who have these characteristics.

KEYWORDS:

Chemotherapy; Platinum free interval; Platinum-refractory ovarian cancer; Platinum-resistant ovarian cancer; Predictive marker; Prognostic marker

PMID:
30982097
DOI:
10.1007/s00280-019-03834-1

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