Routine Clinical Practice for Patients With Recurrent Ovarian Carcinoma: Results From the TROCADERO Study

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Abstract

Objective: Treatment options for patients with recurrent ovarian carcinoma are diverse, and different therapies are recommended based on platinum-free interval (PFI). Data examining the association between platinum sensitivity, treatment strategy, and outcomes are limited, particularly for partially platinum-sensitive (PPS) patients. This study characterized clinical features and outcomes in patients with recurrent ovarian carcinoma in the context of sensitivity to platinum-based therapy.

Methods: Anonymized case records were obtained from eligible European medical sites. Eligible patients were 18 years or older with epithelial ovarian carcinoma who had received 1 or more platinum-based therapies and had 1 or more subsequent relapses. Patient records were categorized by PFI and analyzed based on demographic and clinical data using descriptive statistics.

Results: There was no difference between PFI in PPS patients receiving platinum versus nonplatinum therapy (8.9 [range, 6.0-12.0] and 8.3 [range, 6.0-11.3] months, respectively). Overall survival in patients with platinum-sensitive, PPS, platinum-resistant, and platinum-refractory disease was 43.0 (95% confidence interval [95% CI], 25.1-42.3), 20.5 (95% CI, 17.7-24.8), 12.7 (95% CI, 10.4-14.2), and 9.8 (95% CI, 6.6-14.9) months, respectively. Among PPS patients, overall survival was 23.5 (95% CI, 18.4-37.3) and 18.7 (95% CI, 11.0-23.5) months for those who received platinum and nonplatinum-based therapy, respectively. No demographic or clinical characteristics were identified that indicated a difference between PPS patients who received platinum-based therapy versus those who did not.

Conclusions: Partially platinum-sensitive patients with recurrent ovarian carcinoma who received platinum-based therapy had improved outcomes compared with those who did not. No clear demographic criteria for choosing platinum- versus nonplatinum-based therapy for PPS patients were identified from patient records.

(pdf) .....Several clinical guidelines recommend the use of
platinum-based therapy for PPS patients. However, in the literature,
evidence supporting this treatment choice in PPS patients
specifically is limited. To date, no randomized study has
addressed this specific issue. The TROCADERO study shows
that PPS patients experience better outcomes when they receive
platinum-based therapy; these data lend support to administration
of platinum-based treatment to PPS patients. This study
also revealed that, following first-line therapy, a group of PPS
patients with recurrent disease received non-platinum-based
treatment. This is contrary to several clinical guidelines that
recommend a platinum-based treatment for this patient group.
No criteria were identified that appeared to influence physicians’
selection of a platinum/nonplatinum treatment regimen
in this setting. Further studies will be needed to elucidate criteria
that can be used to guide treatment decisions for patients
with recurrent ovarian carcinoma.