Chemotherapy-free treatments: are we ready for prime time?
D Lorusso 1 , S Pignata 2 , A Gonzalez-Martin 3
Epithelial ovarian cancer (EOC) is most frequently diagnosed at an advanced stage and, despite high response rates to initial taxane-platinum-based chemotherapy, more than 70% of patients will develop recurrent disease and will receive several chemotherapy treatments. At present, the 5-year overall survival (OS) for women diagnosed with stage III–IV disease is ∼46% and patients with genetic impairments of DNA repair pathways [BRCA mutations and in general homologous recombination deficiency (HRD)] live longer and possibly will receive even more lines of chemotherapy [1.].
The cumulative toxicity of chemotherapy, particularly if platinum-based, in terms of neurotoxicity, nephrotoxicity and myelotoxicity, is a limiting factor in patients scheduled to receive multiple lines of treatment. Moreover, allergic reactions to platinum, whose frequency increases with multiple treatment lines, is a great challenge, particularly in long-surviving patients. Finally, the risk of secondary tumors, particularly in HRD patients, seems to be related to the number of previous chemotherapy lines—and platinum in particular—thus introducing important concerns on the long-term safety of patients [2.].
CITATION Ann Oncol. 2019 Apr 1;30(4):497-498. doi: 10.1093/annonc/mdz079