Rechallenge with platinum-based chemotherapy in patients with platinum-resistant ovarian carcinoma: A cohort study

Background: According to the 2018 ESMO-ESGO consensus conference recommendations on ovarian cancer, platinum rechallenge could be considered in patients with platinum-resistant disease following a treatment with a non‑platinum regimen, if they had not progressed during prior platinum therapy. However, few data are available in this specific setting, especially after the incorporation of novel agents in the current treatment algorithm for ovarian cancer. Methods: We conducted a single-center, retrospective, cohort study to evaluate the activity of platinum rechallenge in patients with high-grade ovarian cancer, progressing on at least one non‑platinum regimen for platinum-resistant disease, from January 2010 to June 2024, at the European Institute of Oncology (Italy). A sample size of 30 patients allowed to estimate a 6-month progression-free survival (PFS) rate of 30 %, with a 95 % confidence interval (CI) ranging from 14 % to 47 %. Results: 30 patients were included: 23 (77 %) received rechallenge with carboplatin and 7 (23 %) with cisplatin. The median number of previous treatment lines was 3 (interquartile range: 3–4). The objective response rate was 27 % (95 % CI: 12–46 %) and the disease control rate was 80 % (95 % CI: 61–92). After a median follow-up of 14.1 months (range: 3.3–52.7), the median PFS was 5.4 months (95 % CI: 2.5–8.2) and the 6-month PFS rate was 47 % (95 % CI: 28–63 %). Conclusions: Platinum rechallenge can be a viable treatment option for selected patients with platinum-resistant ovarian cancer who have previously received a non‑platinum regimen. This study suggests that we could dynamically reassess whether platinum is the best option during the patient's treatment history.