Objective: The goal of this study was to evaluate response to treatment and survival in epithelial ovarian cancer patients with acquired secondary platinum resistance (SPR) compared to patients with primary platinum resistance (PPR). Methods: Patients were categorized as PPR (patients with disease recurrence occurring during or <6 months after completing first-line platinum-based chemotherapy) and SPR (patients with previously platinum-sensitive disease that developed platinum resistance on subsequent treatments). Clinico-pathological variables and treatment outcomes were compared. Results: Of the 118 patients included in this study, 60 had PPR and 58 developed SPR. The SPR women had a significantly higher rate of optimal debulking during their upfront and interval operations, significantly lower CA-125 levels during their primary treatment, and a significantly higher complete and partial response rate to primary chemotherapy. Once platinum resistance appeared, no significant difference in survival was observed between the two groups. The median PFS was 2 months in the PPR group and 0.83 months in the SPR group (p= 0.085). Also, no significant difference was found in post-platinum-resistant relapse survival, with a median of 17.63 months in the PPR and 20.26 months in the SPR group (p= 0.515). Conclusions: Platinum resistance is an important prognostic factor in women with EOC. Patients with SPR acquire the same poor treatment outcome as with PPR. There is a great need for future research efforts to discover novel strategies and biological treatments to reverse resistance and improve survival.
目的：本研究旨在比较获得性继发性铂耐药（SPR）与原发性铂耐药（PPR）的上皮性卵巢癌患者的治疗反应及生存情况。方法：将患者分为PPR组（首次铂类化疗期间或结束后6个月内复发者）和SPR组（既往对铂类敏感但在后续治疗中出现耐药者）。比较两组的临床病理学特征及治疗结局。结果：本研究纳入的118例患者中，60例为PPR，58例发展为SPR。SPR组患者在初始及间歇性肿瘤细胞减灭术中达到理想减瘤的比例显著更高，初次治疗期间CA-125水平显著更低，对初次化疗的完全及部分缓解率显著更高。但一旦出现铂耐药，两组生存期无显著差异：PPR组中位无进展生存期为2个月，SPR组为0.83个月（p=0.085）；铂耐药后复发生存期亦无显著差异，PPR组中位生存期为17.63个月，SPR组为20.26个月（p=0.515）。结论：铂耐药是上皮性卵巢癌患者的重要预后因素。SPR患者与PPR患者同样面临不良治疗结局。亟需未来研究探索逆转耐药、改善生存的新策略及生物治疗方法。
The Poor Prognosis of Acquired Secondary Platinum Resistance in Ovarian Cancer Patients
肿瘤(癌症)患者之家