Overcoming platinum resistance in ovarian cancer treatment: from clinical practice to emerging chemical therapies

Expert Opin Pharmacother. 2017 Oct;18(14):1443-1455. doi: 10.1080/14656566.2017.1328055. Epub 2017 Aug 18.

Abstract

The objective of this review is to summarize results from clinical trials that tested cytotoxic drugs and target strategies for the treatment of platinum resistant (PR) recurrent ovarian cancer (ROC) with particular attention to Phase III and ongoing trials. Areas covered: Since platinum free interval (PFI) represents the most important predictive factor for response to platinum re-treatment in ROC, non-platinum regimens are conventionally considered the most appropriate approaches. Impressive progress has been made in recent decades, resulting in the identification of most effective cytotoxic agents and in the development of new target strategies. However, the efficacy of most of these drugs for the treatment of PR disease is still limited. Expert opinion: The most favorable benefit for the treatment of PR disease, has been described by the AURELIA trial that showed a 3.3 months increase in progression free survival (PFS) when bevacizumab was combined with non-platinum single agent chemotherapy in bevacizumab-naïve patients. Nevertheless, the use of novel agents is associated to important costs for just little gains in survival. Thus, in our opinion the economic evaluation, such as the incorporation of quality of life into the clinical studies is crucial for the development of future trials for PR-ROC.

Keywords: Ovarian cancer; clinical practice; platinum resistance; target therapies.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bevacizumab / administration & dosage
  • Bevacizumab / therapeutic use
  • Carboplatin / administration & dosage
  • Carboplatin / therapeutic use
  • Clinical Trials, Phase III as Topic
  • Disease-Free Survival
  • Drug Resistance, Neoplasm / drug effects*
  • Female
  • Humans
  • Molecular Targeted Therapy
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / mortality
  • Organoplatinum Compounds / administration & dosage
  • Organoplatinum Compounds / therapeutic use
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / mortality
  • Oxaliplatin
  • Quality of Life

Substances

  • Organoplatinum Compounds
  • Oxaliplatin
  • Bevacizumab
  • Carboplatin