Abstract 831P
Background
Current management of recurrent ovarian cancer (OC) is based on the amount of time between completion of latest platinum-based treatment and relapse. Patients with platinum-free interval (PFI) < 6 mo. are considered to be platinum-resistant (PROC) and to have low response rate (RR) to platinum-based chemotherapy.
Methods
We searched PubMed database for all prospective and retrospective full-text articles on the treatment of patients with PROC for all years between 01/01/2000 and 01/06/2019 in English. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) tool was used to ensure transparent reporting of the results. Study inclusion criteria were: 1) morphologically confirmed epithelial OC; 2) standard definition of PROC as a disease that recurred within 6 months after completion of platinum-based chemotherapy; 3) treatment with platinum- or non-platinum chemotherapy with agents that are routinely used for OC; 4) no concomitant therapy with targeted or investigational agents; 5) clearly defined RR for patients with PROC and criteria for response assessment. Pooled analysis of outcomes and multiple linear regression analysis were conducted to assess the impact of platinum salts on probability of response.
Results
We identified 7156 articles. After the review we selected 197 studies for analysis. Of them, 52 (n = 1320) and 145 (n = 6937) trials assessed efficacy of platinum- and non-platinum chemotherapy. Among patients treated with platinum-based and non-platinum chemotherapy RR was 36.04% (95% CI 33.45-38.63) and 14.85% (95% CI 14.01-15.68) respectively. Pooled median PFS was 7.17 months and 3.30 months respectively. In multiple linear regression model administration of platinum chemotherapy was the strongest predictor of RR [B value 0.503 (p < 0.001)]. Cisplatin (RR 39.9%: 95% CI 35.8-44.0%) and carboplatin (RR 42.3%; 95% CI 37.0-47.6%) were associated with better RR compared to oxaliplatin (RR 28.1%; 95% CI 23.9-32.3).
Conclusions
This systematic review shows that patients with 'platinum-resistant' ovarian carcinoma may derive significant benefit from reintroduction of platinum agents and their value should be evaluated in further randomized trials.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.