Redefining Platinum Sensitivity : Additional Treatment Considerations in a Changing Paradigm-Recording

Video Transcription

Video Summary

This IGCS Educational Session, led by Drs. Flora Backus, Wendell Naumann, and Rob Coleman, discusses evolving treatment strategies for recurrent platinum-sensitive ovarian cancer amid changing paradigms influenced by recent trial data. Historically, platinum sensitivity was defined by a six-month progression-free interval post-chemotherapy; patients relapsing within six months were considered platinum-resistant and treated with non-platinum therapies, while those relapsing later were platinum-sensitive and retreated with platinum. However, this binary model oversimplifies a continuum influenced by factors such as histology, molecular signatures, prior therapies, and especially prior exposure to PARP inhibitors.<br /><br />Recent evidence shows that prior PARP inhibitor use reduces response to subsequent platinum and PARP retreatment, challenging traditional rechallenge approaches. In contrast, prior bevacizumab does not seem to impair subsequent therapy efficacy. Trials exploring non-platinum therapies—including antibody-drug conjugates targeting folate receptor alpha—demonstrate promising responses in patients previously treated with PARP inhibitors, signaling new therapeutic options.<br /><br />The experts emphasize the need for refined biomarkers and functional assessments to better predict platinum sensitivity beyond rigid timelines. They advocate for integrating clinical trial participation to optimize therapy sequencing, noting the heterogeneity of ovarian tumors and the potential risks of continuous DNA-damaging agents driving resistance. Future research aims to clarify optimal dosing, treatment duration, and combinations to maximize benefit while minimizing harm, ultimately redefining platinum sensitivity and improving personalized care in ovarian cancer management.

Keywords

platinum-sensitive ovarian cancer

PARP inhibitors

platinum rechallenge

antibody-drug conjugates

folate receptor alpha

biomarkers for platinum sensitivity

ovarian cancer treatment strategies