Journal of Cancer Research and Treatment
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Journal of Cancer Research and Treatment. 2016, 4(2), 32-36
DOI: 10.12691/jcrt-4-2-3
Open AccessReview Article

Management of Platinum Resistant – Refractory Ovarian Cancer: A Short Review

S.G.D. Ganghadaran1,

1Department of Medical oncology, Govt.Royapettah Hospital, Chennai, India

Pub. Date: May 30, 2016

Cite this paper:
S.G.D. Ganghadaran. Management of Platinum Resistant – Refractory Ovarian Cancer: A Short Review. Journal of Cancer Research and Treatment. 2016; 4(2):32-36. doi: 10.12691/jcrt-4-2-3


Ovarian cancer accounts for 3% of cancer deaths among women and is the most lethal gynecological malignancy. The five year survival for all stages collectively is 45.6% and relapsed ovarian cancer is incurable. Platinum resistance is a major prognostic determinant but the molecular pathways involved in resistance mechanism are unknown. Resistance prediction methods are only evolving. The goal of therapy is preservation of performance status and quality of life. Sequential single agent chemotherapy offers the best benefit however no preferred sequence is recommended. Incorporating targeted therapy with conventional chemotherapy presents attractive additional therapeutic options with bevacizumab and olaparib licensed for clinical use. Survival with current management is dismal and enrollment in a clinical trial offers the best scope for platinum resistant ovarian cancer patients.

ovarian cancer platinum resistance cisplatin refractory management

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[1]  American cancer society.Cancer facts and figures 2014.
[2]  Siegel RL1, Miller KD, Jemal A, Cancer statistics, 2015 Cancer J Clin. 2015 Jan-Feb;65(1):5-29.
[3]  National cancer institute, SEER programme
[4]  F. M. Muggia, P S. Braly, M F. Brady et al. Phase III Randomized Study of Cisplatin Versus Paclitaxel Versus Cisplatin and Paclitaxel in Patients With Suboptimal Stage III or IV Ovarian Cancer: A Gynecologic Oncology Group Study ;J clini Onco Jan 1, 2000:106.
[5]  du Bois A, Lück HJ, Meier W et al. Carboplatin/paclitaxel versus cisplatin/paclitaxel as first-line chemotherapy in advanced ovarian cancer: an interim analysis of a randomized phase III trial of the Arbeitsgemeinschaft Gynäkologische Onkologie Ovarian Cancer Study Group Semin Oncol. 1997 Oct;24 (5 Suppl 15):S15-44-S15-52.
[6]  Markman M, Bookman MA. Second-line treatment of ovarian cancer. Oncologis 2000 5, 26-35.
[7]  Pfisterer J, Ledermann JA Management of platinum-sensitive recurrent ovarian cancer. Semin Oncol. 2006 Apr; 33(2 Suppl 6):S12-6.
[8]  Friedlander M, Trimble E, Tinker A et al. Clinical trials in recurrent ovarian cancer. Int. J. Gynecol. Cancer 2011,21,771-775.
[9]  G Rustin, I Vergote, E.Eisenhauer et al Definitions for Response and Progression in Ovarian Cancer Clinical Trials Incorporating RECIST 1.1 and CA 125 Agreed by the Gynecological Cancer Intergroup (GCIG) ;Int J Gynecol Cancer 2011;21: 419-423.
[10]  Jeremy Chien, Rui Kuang, Charles Landen, and V.Shridhar Platinum-Sensitive Recurrence in Ovarian Cancer: The Role of Tumor Microenvironment, Front Oncol. 2013; 3: 251.
[11]  Sherman-Baust CA, Weeraratna AT, Rangel LB, et al Remodeling of the extracellular matrix through overexpression of collagen VI contributes to cisplatin resistance in ovarian cancer cells Cancer Cell. 2003 Apr; 3(4):377-86.
[12]  Gonzalo Tapia and Ivan Diaz-Padilla (2013). Molecular Mechanisms of Platinum Resistance in Ovarian Cancer, Ovarian Cancer - A Clinical and Translational Update, Dr. Ivan Diaz-Padilla (Ed.), InTech.
[13]  H J. Burstein, PB. Mangu, M R. Somerfield et al. American Society of Clinical Oncology Clinical Practice Guideline Update on the Use of Chemotherapy Sensitivity and Resistance Assays. J clin Onco 2011; 29.
[14]  Krivak TC, Lele S, Richard S, et al, A chemoresponse assay for prediction of platinum resistance in primary ovarian cancer. Am J Obstet Gynecol 2014; 211: 68 e 1-8.
[15]  Piccart MJ1, Bertelsen K, James K et al. Randomized intergroup trial of cisplatin-paclitaxel versus cisplatin-cyclophosphamide in women with advanced epithelial ovarian cancer: three-year results. J Natl Cancer Inst. 2000 May 3;92(9):699-708.
[16]  Ovarian Cancer Meta-Analysis Project: cyclophosphamide plus cisplatin versus cyclophosphamide, doxorubicin, and cisplatin chemotherapy of ovarian carcinoma: a meta-analysis. J Clin Oncol 1991;9:1668-1674.
[17]  Gabizon A, Catane R, Uziely R et al. Prolonged circulation time and enhanced accumulation in malignant exudates of doxorubicin encapsulated in polyethylene-glycol coated liposomes. Cancer Res 1994;54:987-992.
[18]  Berri G, Billingham M, Alderman E et al. The use of cardiac biopsy to demonstrate reduced cardiotoxicity in AIDS Kaposi's Sarcoma patients with pegylated liposomal doxorubicin. Ann Oncol 1998;9:711-716.
[19]  Ten Bokkel Huinink W, Gore M, Carmichael J et al. Topotecan versus paclitaxel for the treatment of recurrent epithelial ovarian cancer. J Clin Oncol 1997;15:2183-2193.
[20]  Cremers GJ, Bolis G, Gore M et al. Topotecan, an active drug in the second-line treatment of epithelial ovarian cancer: results of a large European phase II study. J Clin Oncol 1996;14:3056-3061.
[21]  Bookman MA, Malmström H, Bolis G et al. Topotecan for the treatment of advanced epithelial ovarian cancer: an open-label phase II study in patients treated after prior chemotherapy containing cisplatin or carboplatin and paclitaxel. J Clin Oncol 1998;16:3345-3352.
[22]  A E Green, P G Rose, Pegylated liposomal doxorubicin in ovarian cancer Int J Nanomedicine. 2006 Sep; 1(3): 229-239.
[23]  D. Lorusso, A. Di Stefano, F. Fanfani et al. Role of gemcitabine in ovarian cancer treatment; 2006 Annals of Oncology 17 (Supplement 5): v188–v194.
[24]  S. Kumar, H. Mahdi, C Bryant, et al. Clinical trials and progress with paclitaxel in ovarian cancer ; Int J Womens Health. 2010; 2: 411-427.
[25]  Francis P, Schneider J, Hann L et al. Phase II trial of docetaxel in patients with platinum-refractory advanced ovarian cancer. J Clin Oncol 1994;12:2301-2308.
[26]  Kaye SB, Piccart M, Aapro M et al. Docetaxel in advanced ovarian cancer: preliminary results from three phase II trials. Eur J Cancer 1995;31A(suppl 4):S14-S17.
[27]  Piccart MJ, Gore M, ten Bokkel Huinink W et al. Docetaxel: an active new drug for treatment of advanced epithelial ovarian cancer. J Natl Cancer Inst 1995;87:676-681.
[28]  Markman M, Hakes T, Reichman B et al. Phase 2 trial of chronic low dose oral etoposide as salvage therapy of platinum-refractory ovarian cancer. J Cancer Res Clin Oncol 1992;119:55-57.
[29]  Vergote I,Himmelmann A, Frankendal B et al. Hexamethylmelamine as second-line therapy in platin-resistant ovarian cancer. Gynecol Oncol 1992;47:282-286.
[30]  G Aravantinos, D. Bafaloukos, G. Fountzilas et al. Phase II study of docetaxel–vinorelbine in platinum-resistant, paclitaxel-pretreated ovarian cancer; Annals of Oncology 2003 14: 1094-1099.
[31]  Rothenberg ML, Liu PY, Wilczynski S et al. Phase II trial of vinorelbine for relapsed ovarian cancer: a Southwest Oncology Group study ;Gynecol Oncol. 2004 Dec;95(3):506-12.
[32]  H. Egloffa and A.Jatoi, Pemetrexed for Ovarian Cancer: A Systematic Review of the Published Literature and a Consecutive Series of Patients Treated in a Nonclinical Trial Setting ; Case Rep Oncol. 2014 May-Aug; 7(2): 541-549.
[33]  Tropé C, Marth C, Kaern J Tamoxifen in the treatment of recurrent ovarian carcinoma; Eur J Cancer. 2000 Sep; 36 Suppl 4:S59-61.
[34]  Argenta PA, Thomas SG, Judson PL et al. A phase II study of fulvestrant in the treatment of recurrent epithelial ovarian cancer; Gynecol Oncol. 2009 May; 113(2):205-9.
[35]  Del Carmen MG, Fuller AF, Matulonis U et al, A Phase II trial of anastrozole in women with asymptomatic müllerian cancer. Gynecol Oncol. 2003 Dec; 91(3):596-60.
[36]  Bowman A, Gabra H, Langdon SP et al. CA125 response is associated with estrogen receptor expression in a phase II trial of letrozole in ovarian cancer: identification of an endocrine-sensitive subgroup. Clin Cancer Res. 2002 Jul; 8(7):2233-9.
[37]  Du Bois, W. Meier, H. J. Lück et al Chemotherapy versus hormonal treatment in platinum- and paclitaxel-refractory ovarian cancer: a randomised trial of the German Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) Study Group Ovarian Cancer ; Ann Oncol (2002) 13 (2): 251-257.
[38]  Cannistra SA1, Matulonis UA, Penson RT et al Phase II study of bevacizumab in patients with platinum-resistant ovarian cancer or peritoneal serous cancer. J Clin Oncol. 2007 Nov 20;25(33): 5180-6.
[39]  Pujade-Lauraine E, Hilpert F, Weber B, et al. Bevacizumab combined with chemotherapy for platinum-resistant recurrent ovarian cancer: The AURELIA open-label randomized phase III trial. J Clin Oncol. 2014 May 1; 32(13):1302-8.
[40]  B. Kaufman, R.Frommer, R. K. Schmutzler et al.M. Olaparib Monotherapy in Patients With Advanced Cancer and a Germline BRCA1/2 Mutation J Clin Oncol. 2015 Jan 20;33(3):244-50.
[41]  Audeh MW, Carmichael J, Penson RT et al. Oral poly(ADP-ribose) polymerase inhibitor olaparib in patients with BRCA1 or BRCA2 mutations and recurrent ovarian cancer: a proof-of-concept trial. Lancet. 2010 Jul 24; 376(9737):245-51.
[42]  K. L Lloyd, I. A Cree, and R. S Savage, Prediction of resistance to chemotherapy in ovarian cancer: a systematic review, BMC Cancer. 2015; 15: 117.
[43]  K.Matsuo, Y.G. Lin, MD, MS,2,3 L. D. Roman, MD, and A. K. Sood, Overcoming Platinum Resistance in Ovarian Carcinoma, Expert Opin Investig Drugs. 2010 Nov; 19(11): 1339-1354.