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Multicenter retrospective study to evaluate the impact of trabectedin plus pegylated liposomal doxorubicin on the subsequent treatment in women with recurrent, platinum-sensitive ovarian cancer

Romero, Ignacioa; Mallol, Pedroc; Santaballa, Anab; Del Campo, Jose M.d; Mori, Martah; González-Santiago, Santiagoi; Casado, Antonioj; Vicente, Davidn; Ortega, Eugeniao; Herrero, Anao; Guerra, Evak; Barretina-Ginesta, Pilarp; Rubio, María J.q; Martínez, Alejandroe; Bover, Isabelr; Vidal, Laural; Arcusa, Ángelsf; Martín, Lolas; García, Yolandag; González-Martín, Antoniom

doi: 10.1097/CAD.0000000000000794
CLINICAL REPORT
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Debulking surgery, followed by taxane/platinum-based chemotherapy has traditionally been the first-line treatment for advanced ovarian cancer. However, most patients will experience recurrence afterwards, and receive subsequent lines of therapy. It has been proposed that extending the treatment-free interval of platinum can improve the response to a subsequent platinum-based chemotherapy, and reduce associated toxicities in women with recurrent, platinum-sensitive ovarian cancer. The aim was to determine the impact, in clinical practice, of trabectedin with pegylated liposomal doxorubicin (trabectedin/PLD) on the subsequent platinum-based therapy in these patients, and to explore the prognosis for breast cancer gene status and the expression of diverse genes. This was a multicenter, retrospective, postauthorization study that involved 79 patients. Germline or somatic mutations of breast cancer gene 1/2 were present in 21.5%. The median time between trabectedin/PLD and the onset of the subsequent treatment was 6.7 months. The overall response rate during the trabectedin/PLD period was 36.7%. In the subsequent first-line platinum-based therapy, the overall response rate was 51.4%. Progression-free survival and overall survival were 11.8 and 25.4 months, respectively, from the onset of trabectedin/PLD treatment. Partially platinum-sensitive (between 6 and 12 months) and platinum-sensitive patients (treatment-free interval of platinum≥12 months) showed no differences in progression-free survival and overall survival. Grade 3 neutropenia and asthenia were reported in 15.2 and 10.1% of patients, respectively. Most frequent adverse events in more than 10% of patients were neutropenia (45.6%), asthenia (43.0%), nausea (25.3%), and anemia (13.9%). The intercalation with a nonplatinum regimen may improve the response to a subsequent platinum-based therapy in women with recurrent, platinum-sensitive ovarian cancer.

aValencia Institute of Oncology

bLa Fe Hospital, Valencia

cDiagonal Clinic

dHospital Vall d’Hebrón

eQuirón Dexeus University Hospital

fTerrassa Hospital

gParc Tauli Hospital, Barcelona

hDoctor Negrín Gran Canaria University Hospital, Canary Islands

iSan Pedro de Alcántara Hospital, Cáceres

jSan Carlos Clinical University Hospital

kRamón y Cajal Hospital

lSyneos Health

mNavarra University Clinic Madrid

nVirgen Macarena University Hospital, Seville

oMiguel Servet University Hospital, Zaragoza

pGirona Institut Català d’Oncologia, Girona

qReina Sofia Hospital, Córdoba

rSon Llátzer Hospital, Balear Islands

sSant Joan de Reus University Hospital, Tarragona, Spain

Correspondence to Ignacio Romero, MD, Fundación Instituto Valenciano de Oncología, C/ Profesor Beltrên Baguena, no.8 Edificio D (Nuevo Edificio), Planta 1a, Valeneia 46009, Spain Tel: +96 111 4229; fax: +96 111 4344; e-mail: iromero@fivo.org

Received November 9, 2018

Accepted March 28, 2019

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