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Expert Rev Anticancer Ther. 2018 Oct;18(sup1):13-17. doi: 10.1080/14737140.2018.1513792.

Recurrent ovarian cancer 8 months after induction and bevacizumab consolidation: rationale for using trabectedin + pegylated liposomal doxorubicin in second line.

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a European Institute of Oncology , University of Milan-Bicocca , Milan , Italy.



Ovarian cancer patients with relapse 6-12 months after last platinum treatment, who have received bevacizumab consolidation and are not BRCA mutant, represent a considerable therapeutic challenge.


By means of illustrative case study, this review evaluates various treatment strategies for use at first relapse in an ovarian cancer patient with limited sensitivity to platinum.


Clinical parameters predictive of complete resection in secondary cytoreductive surgery include an Eastern Cooperative Oncology Group performance status of 0, no residual disease after first surgery, and <500 mL of ascites. Options for systemic therapy include platinum-based therapies, non-platinum combinations, and non-platinum single agents. The patient's circumstances suggested that the non-platinum combination of trabectedin + pegylated liposomal doxorubicin (PLD) would be most appropriate. Trabectedin + PLD may enhance response to the next platinum cycle and thus prolong survival although this hypothesis requires confirmation. At minimum, trabectedin + PLD provides additional time for patients to recover from previous platinum toxicity while receiving an effective treatment.


In recurrent ovarian cancer patients with expected suboptimal response to platinum, trabectedin + PLD may offer an active alternative, which differs from the first-line schedule, and may enhance the efficacy of subsequent platinum rechallenge.


Recurrent ovarian cancer; non-platinum combinations; sequence effect; trabectedin

[Indexed for MEDLINE]

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