The concept of “platinum sensitivity” has long guided prognostic assessment and treatment selection in recurrent ovarian cancer. However, the emergence of targeted agents, such as bevacizumab and poly (ADP-ribose) polymerase inhibitors, has complicated its clinical utility. In contrast, emerging evidence suggests that platinum sensitivity may also be applicable to recurrent endometrial cancer. As in ovarian cancer, a prolonged platinum-free interval (PFI) in recurrent endometrial cancer is associated with an improved efficacy of subsequent platinum-based chemotherapy. The PFI is linearly correlated with the response rate to platinum re-administration, progression-free survival, and overall survival. Patients are typically classified as having platinum-resistant or platinum-sensitive disease based on a PFI cutoff of 6 or 12 months. However, unlike in ovarian cancer—where the duration of response to second-line platinum-based chemotherapy rarely exceeds the prior PFI (~3%)—approximately 30% of patients with recurrent endometrial cancer exhibit a sustained response to platinum rechallenge that extends beyond their preceding PFI. Despite the incorporation of immune checkpoint inhibitors into the treatment landscape of endometrial cancer, the role of platinum sensitivity in clinical decision-making—particularly regarding treatment sequencing and drug selection—remains a critical and unresolved issue. Further research is warranted to elucidate the mechanisms underlying platinum resistance and to guide optimal therapeutic strategies.
“铂类敏感性”这一概念长期以来指导着复发性卵巢癌的预后评估与治疗选择。然而，随着贝伐珠单抗及聚腺苷二磷酸核糖聚合酶抑制剂等靶向药物的出现，其临床适用性变得复杂化。与此相对，新近证据表明铂类敏感性概念可能同样适用于复发性子宫内膜癌。与卵巢癌相似，复发性子宫内膜癌中较长的铂类无药间期与后续铂类化疗疗效改善相关。铂类无药间期与铂类再给药后的缓解率、无进展生存期及总生存期呈线性相关。临床通常以6个月或12个月为界，将患者划分为铂类耐药型或铂类敏感型疾病。然而，与卵巢癌中二线铂类化疗的缓解持续时间极少超过既往铂类无药间期（约3%）的情况不同，约30%的复发性子宫内膜癌患者对铂类再挑战表现出持续缓解，且持续时间超过其既往铂类无药间期。尽管免疫检查点抑制剂已被纳入子宫内膜癌的治疗体系，铂类敏感性在临床决策——特别是治疗序贯与药物选择方面——的作用仍是至关重要且尚未解决的问题。需要进一步研究以阐明铂类耐药的内在机制，并指导优化治疗策略。
肿瘤(癌症)患者之家