Heterogeneous effects of cytotoxic chemotherapies for platinum-resistant ovarian cancer

by Selleckchem | Nov 03 2023

Background: Single-agent chemotherapy with or without bevacizumab (Bev) is a standard therapy for platinum-resistant ovarian cancer (PR-OC). However, there is a lack of literature on chemotherapy agent selection in heterogenous PR-OC. Therefore, we aimed to clarify the heterogeneous treatment effects of each chemotherapy agent.

Methods: Patients who underwent single-drug chemotherapy agents or Bev combination therapy for PR-OC between January 2009 and June 2022 were included in this study. We assessed the impact of each chemotherapy agent on the time to treatment failure (TTF) according to histological type, platinum-free interval (PFI), and Bev usage.

Results: A total of 158 patients received 343 different chemotherapy regimens. In patients with clear cell carcinoma/mucinous carcinoma (CC/MC), gemcitabine (GEM) had the strongest effect with a median TTF of 5.3 months, whilst nedaplatin (NDP) had the lowest effect with a median TTF of 1.4 months. In contrast, in the non-CC/MC group, irinotecan (CPT-11) and NDP had a better TTF than GEM and pegylated liposomal doxorubicin (PLD). There were notable differences in the treatment efficacy of NDP according to PFI. Specifically, NDP prolonged the TTF in patients with a PFI ≥ 3 months. Compared with GEM alone, GEM + Bev tended to prolong the TTF more effectively; however, an additive effect was not observed with PLD + Bev.

Conclusions: This study demonstrated that the effect of chemotherapy agents differed according to the tumor and background characteristics of the patient. Our findings will improve selection of effective therapies for patients with PR-OC by considering their background characteristics.

Comments:

The study you mentioned aimed to investigate the heterogeneous treatment effects of various chemotherapy agents in patients with platinum-resistant ovarian cancer (PR-OC). The researchers analyzed the impact of each chemotherapy agent on the time to treatment failure (TTF) based on histological type, platinum-free interval (PFI), and the use of bevacizumab (Bev) in combination with chemotherapy.

The study included a total of 158 patients who received 343 different chemotherapy regimens between January 2009 and June 2022. The results showed that the efficacy of chemotherapy agents varied depending on the histological type of the tumor. In patients with clear cell carcinoma/mucinous carcinoma (CC/MC), gemcitabine (GEM) had the strongest effect, with a median TTF of 5.3 months. On the other hand, nedaplatin (NDP) had the lowest effect, with a median TTF of 1.4 months in this group.

In the non-CC/MC group, irinotecan (CPT-11) and NDP had a better TTF compared to GEM and pegylated liposomal doxorubicin (PLD). Additionally, the study found notable differences in the treatment efficacy of NDP based on the platinum-free interval (PFI). NDP was found to prolong the TTF in patients with a PFI of 3 months or longer.

Regarding the use of bevacizumab, the combination of GEM and Bev tended to prolong the TTF more effectively compared to GEM alone. However, there was no observed additive effect with the combination of PLD and Bev.

In conclusion, this study highlighted the importance of considering the tumor and background characteristics of patients with PR-OC when selecting chemotherapy agents. The efficacy of different agents varied depending on factors such as histological type, platinum-free interval, and the use of bevacizumab. These findings provide valuable insights for improving the selection of effective therapies for patients with platinum-resistant ovarian cancer.