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• W3195956791 abstract "Objectives: Though patients with partially platinum-sensitive diseases (PFI, 6-12 months) experience a relatively low response rate to platinum in the platinum-sensitive population, there is uncertainty whether prolonging the PFI by introducing non-platinum treatment could improve the outcome of patients with partially platinum-sensitive ovarian cancer. The objective of our meta-analysis is to identify whether platinum-free chemotherapy could improve overall survival in partially platinum-sensitive relapsed ovarian cancer than platinum-based chemotherapy. Methods: We systematically searched for studies about treatments of relapsed ovarian cancer published between 2000 and 2020 in online databases Medline, PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). Studies reporting the use of platinum-free and platinum-based chemotherapies in partially platinum-sensitive relapsed ovarian cancer, as well as corresponding overall survivals, were selected. Statistical meta-analysis was performed with the ‘meta’ package in R studio software. Results: Of 2,387 initial references, four studies were involved, including 1,167 partially platinum-sensitive patients with relapsed ovarian cancer, among whom 530 patients (45.4%) received platinum-free chemotherapy. Meanwhile, the remaining 637 patients (54.6%) received platinum-based chemotherapy. Three studies involving four comparable groups showed trends towards longer median overall survivals in patients with platinum versus no platinum, while the study, INOVATYON showed similar overall survival between trabectedin/pegylated liposomal doxorubicin (PLD) and PLD/carboplatin treated groups. Two studies both reported diminished quality of life in the platinum-free chemotherapy arm versus platinum-based chemotherapy arm. Finally, the meta-analysis showed that progression-free survival is significantly shorter in platinum-free chemotherapy groups compared to platinum-based chemotherapy (hazard ratio, HR, 0.76; 95% confidence interval, 95% CI 0.62-0.89, P<0.001, fixed-effects model) (Figure 1B), and platinum-free chemotherapy does not prolong overall survival in partially platinum-sensitive relapsed ovarian cancer compared to platinum-based chemotherapy (HR, 0.81; 95% CI, 0.57-1.05, P<0.001, random-effects model) (Figure 1A). Conclusions: Compared to platinum-based chemotherapy, overall survival was not improved by a platinum-free counterpart in partially platinum-sensitive relapsed ovarian cancer, and even there appears to be a trend towards favouring platinum. Platinum-based therapy still benefits partially platinum-sensitive relapsed ovarian cancer, and platinum-based therapy should be compared with maintenance therapy in this population in the future. Though patients with partially platinum-sensitive diseases (PFI, 6-12 months) experience a relatively low response rate to platinum in the platinum-sensitive population, there is uncertainty whether prolonging the PFI by introducing non-platinum treatment could improve the outcome of patients with partially platinum-sensitive ovarian cancer. The objective of our meta-analysis is to identify whether platinum-free chemotherapy could improve overall survival in partially platinum-sensitive relapsed ovarian cancer than platinum-based chemotherapy. We systematically searched for studies about treatments of relapsed ovarian cancer published between 2000 and 2020 in online databases Medline, PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). Studies reporting the use of platinum-free and platinum-based chemotherapies in partially platinum-sensitive relapsed ovarian cancer, as well as corresponding overall survivals, were selected. Statistical meta-analysis was performed with the ‘meta’ package in R studio software. Of 2,387 initial references, four studies were involved, including 1,167 partially platinum-sensitive patients with relapsed ovarian cancer, among whom 530 patients (45.4%) received platinum-free chemotherapy. Meanwhile, the remaining 637 patients (54.6%) received platinum-based chemotherapy. Three studies involving four comparable groups showed trends towards longer median overall survivals in patients with platinum versus no platinum, while the study, INOVATYON showed similar overall survival between trabectedin/pegylated liposomal doxorubicin (PLD) and PLD/carboplatin treated groups. Two studies both reported diminished quality of life in the platinum-free chemotherapy arm versus platinum-based chemotherapy arm. Finally, the meta-analysis showed that progression-free survival is significantly shorter in platinum-free chemotherapy groups compared to platinum-based chemotherapy (hazard ratio, HR, 0.76; 95% confidence interval, 95% CI 0.62-0.89, P<0.001, fixed-effects model) (Figure 1B), and platinum-free chemotherapy does not prolong overall survival in partially platinum-sensitive relapsed ovarian cancer compared to platinum-based chemotherapy (HR, 0.81; 95% CI, 0.57-1.05, P<0.001, random-effects model) (Figure 1A). Compared to platinum-based chemotherapy, overall survival was not improved by a platinum-free counterpart in partially platinum-sensitive relapsed ovarian cancer, and even there appears to be a trend towards favouring platinum. Platinum-based therapy still benefits partially platinum-sensitive relapsed ovarian cancer, and platinum-based therapy should be compared with maintenance therapy in this population in the future." @default.
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• W3195956791 date "2021-08-01" @default.
• W3195956791 modified "2023-10-18" @default.
• W3195956791 title "Relapsed ovarian cancer: a systematic review and meta-analysis" @default.
• W3195956791 doi "https://doi.org/10.1016/s0090-8258(21)01102-1" @default.
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