abstract: Predicting platinum resistance in primary advanced ovarian cancer patients with an in vitro resistance index

PURPOSE:

We aimed to identify primary platinum resistance in epithelial ovarian cancer (OC) patients with FIGO stage III-IV disease by an in vitro drug-response assay and to correlate the findings with clinical response. We considered whether neoadjuvant chemotherapy or anatomic sample site and tumor heterogeneity would influence the results.

CONCLUSIONS:

This in vitro assay predicted primary platinum resistance, without misclassification of sensitive OC patients, and the results were significantly associated with PFS. We suggest that samples from primary tumor and metastatic samples have different responses to chemotherapy and that exposure to chemotherapy might induce in vitro platinum resistance.

free full access: Chemosensitivity and outcome of BRCA1- and BRCA2-associated ovarian cancer patients after first-line chemotherapy compared with sporadic ovarian cancer patients — Ann Oncol

full free access: The Role of In Vitro Directed Chemotherapy in Epithelial Ovarian Cancer

Epithelial ovarian cancer (EOC) continues to be the most lethal gynecologic malignancy. Efforts to personalize chemotherapy treatments by utilizing in vitro tumor assays to predict chemotherapeutic response have been tested in both the primary and recurrent treatment setting. To date, several retrospective studies have suggested improved response rates to predicted chemotherapeutic agents. However, a prospective, controlled trial merely found equivalence between in vitro prediction and empirical treatment selection. This review summarizes the current data regarding in vitro directed chemotherapy in EOC.

Conclusions: In vitro chemotherapy sensitivity and resistance testing may still hold promise for clinical decision-making, improved survival, and limiting unnecessary toxicity in the treatment of EOC. Given the current limitations and lack of randomized, controlled results, these assays are best used in the setting of a clinical trial.