J Gynecol Oncol.
2021 May;32(3):e37. 10.3802/jgo.2021.32.e37.
Primary platinum resistance and its prognostic impact in patients with recurrent ovarian cancer: an analysis of three prospective trials from the NOGGO study group
- Trillsch F
1 - Mahner S1
- Czogalla B1
- Rottmann M2
- Chekerov R3
- Braicu EI3
- Oskay-Öczelik G4
- Wimberger P5
- Richter R3
- Sehouli J3
- Affiliations
-
- 1Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
- 2Munich Cancer Registry, Bavarian Cancer Registry - Regional Centre Munich (LGL) at the University Hospital of Munich, Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany
- 3Charité Universitaetsmedizin Berlin, Department of Gynecology, Campus Virchow Klinikum, Berlin, Germany
- 4Praxisklinik Krebsheilkunde, Berlin, Germany
- 5Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- KMID: 2526394
- DOI: http://doi.org/10.3802/jgo.2021.32.e37
Abstract
Objective
Patients with platinum-resistant ovarian cancer (PROC) have a high need for reliable prognostic markers. Since significance of primary platinum resistance (PPR) versus secondary platinum resistance (SPR) was identified for patients receiving anti-angiogenic therapy, it has not been confirmed for chemotherapy only.
Methods
PROC patients from 3 prospective trials of the NOGGO study group (TOWER, NOGGO-Treosulfan, and TRIAS) were included in this meta-analysis. Exploratory Cox and logistic regression analyses were performed to correlate progression-free survival (PFS) and overall survival (OS) with the timing when platinum resistance developed.
Results
Of 477 patients, 264 (55.3%) were classified as PPR, compared to 213 (44.7%) with SPR. For patients receiving chemotherapy only, SPR was associated with a significantly longer median PFS of 3.9 compared to 3.1 months for PPR (hazard ratio [HR]=0.78; p=0.015). SPR versus PPR was confirmed to be an independent prognostic factor for better PFS in multivariate analysis (HR=0.74; p=0.029). Benefit from adding sorafenib to chemotherapy was mainly seen in PPR (HR=0.40; p<0.001) compared to SPR patients (HR=0.83; p=0.465).
Conclusions
Prognostic significance of SPR versus PPR could be elucidated for patients receiving chemotherapy only. In contrast to bevacizumab, the multi-kinase inhibitor sorafenib exhibits profound therapeutic efficacy in PPR patients indicating potential to overcome this negative prognostic impact.
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