Trabectedin-pegylated liposomal doxorubicin compared to cisplatin desensitization regimen-paclitaxel in ovarian cancer patients

Treatment with trabectedin/pegylated liposomal doxorubicin (PLD) has shown effec-tiveness in patients with platinum-sensitive recurrent ovarian cancer (ROC). The study evaluates whether this chemotherapy combination may replace treatment with cisplatin desensitization regimen combined with paclitaxel in platinum-sensitive ROC patients when carboplatin is contraindicated. Thirty-nine ROC patients treated with multiple lines of chemotherapy who had developed hypersensitivity (84%, n = 32) or other adverse events (16%, n = 7) to carboplatin were included in this observational study (10 June 2009–31 May 2019). Two ROC cohorts were evaluated for clinical outcomes: Sixteen patients received trabectedin and PLD (T-cohort) and 23 patients received cisplatin desensitization regimen and paclitaxel (C-cohort). The primary diagnosis of ovarian cancer stage I–IV were from September 1986 to December 2016, last observation date was 31 December 2022. The response rate among the patients in the T-cohort was lower than in the C-cohort (63% vs. 92%, p < 0.05). Progression free survival (PFS) was 110 and 43 months in the T- and C-cohort, respectively (p = 0.16). In regards to adverse events, two patients in the C-cohort had life-threatening serious adverse events (SAE) compared to none in the T-cohort, whereas more patients in the T-cohort (56%, n = 9) had grade 3 SAE compared to patients in the C-cohort (22%, n = 5). Sixty-nine percent (n = 11) and 52% (n = 12) had fatigue in the respective cohorts. Thirty-eight and 37% of the patients had previous received more than two lines of chemotherapy, respectively. Five patients had crossed over to either the T- (n = 1) or the C-cohort (n = 4) in a later recurrence. Treatment with trabectedin and PLD is a good alternative to cisplatin desensitization regimen combined with paclitaxel in patients with platinum sensitive ROC when platinum is contraindicated.

Gynecological cancer; Ovarian cancer; Chemotherapy; Adverse events; Platinum; Trabectedin; Pegylated liposomal doxorubicin; Carboplatin; Cisplatin desensitization; Paclitaxel

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