Long-term effect of pegylated liposomal doxorubicin in recurrent platinum-resistant ovarian cancer: а clinical case

Abstract

Despite the high initial susceptibility of ovarian cancer (OC) to chemotherapy, the vast majority of patients with Stages III–IV of the disease have its recurrences. Chemotherapy is a main treatment for recurrent OC. In Russia, the rate of platinum-resistant recurrences after first-line chemotherapy is more than 50 %, which may be due to the high extent of a tumor process at the moment of diagnosis, to the low rate of optimal cytoreductive interventions, and to non-optimal treatment. Many oncologists refuse to treat patients with recurrent platinum-resistant OC since the existing Russian and foreign guidelines point to the low efficiency of current chemotherapy for this type of recurrences. At the same time, whether chemotherapy should be used to treat platinum-resistant recurrences must be decided by taking into account a set of clinical factors that along with the duration of a platinum-free interval are also predictors for the efficiency of chemotherapy. These predictors should include mainly the histological pattern of a tumor; an immediate response to previous lines of chemotherapy; the number of previously used anticancer drugs; a patient’s general condition; and her existing factors that can influence the tolerability of chemotherapy. This paper describes a clinical case of a long-term survival in an OC patient who has developed a platinum-resistant recurrence just after first-line chemotherapy. Incomplete cross-resistance of the tumor to other drugs when a platinum-resistance recurrence develops, as well as its high susceptibility to the re-use of platinum-resistant derivatives possibly due to the artificial increase of a platinum-free interval should be identified among the factors that have influenced the prediction of treatment in this patient.