Trabectedin + pegylated liposomal doxorubicin in third-line treatment of platinum-sensitive relapsed ovarian cancer: a case study.

BACKGROUND: The challenges of managing relapsed ovarian cancer increase as more advanced lines of chemotherapy are achieved.

METHODS: A case study is presented to illustrate the complexities of selecting treatment in a patient with platinum-sensitive relapsed ovarian cancer and exposure to two previous lines of platinum-based chemotherapy.

RESULTS: In this clinical scenario, options include re-treatment with platinum-based chemotherapy or treatment with a nonplatinum single-agent or a nonplatinum combination. In this case, the nonplatinum combination of trabectedin + pegylated liposomal doxorubicin (PLD) was selected as the patient had limited platinum sensitivity (progression-free interval of 9 months), no BRCA mutation, and taking into account evidence that the regimen is effective and safe in the third line and beyond and may restore platinum sensitivity. After nine cycles of trabectedin + PLD, there was no evidence of disease. The patient was able to resume normal activities during therapy. Progression-free interval (PFI) was 17 months before disease progression. Subsequent platinum rechallenge produced a partial response.

CONCLUSION: Trabectedin + PLD may be an option for patients with platinum-sensitive relapsed ovarian cancer, including those who have received two or more previous lines of platinum.