Open AccessEfficacy of non‑platinum chemotherapy in platinum‑resistant ovarian cancer: a meta‑analysis
Author(s) -
A. A. Rumyantsev,
Alexandra Tyulyandina,
E. R. Israelyan,
I. A. Pokataev,
Mikhail Fedyanin,
E. V. Glazkova,
Y. Sergeev,
S. Tjulandin
Publication year - 2022
Publication title -
zlokačestvennye opuholi
Language(s) - English
Resource type - Journals
eISSN - 2587-6813
pISSN - 2224-5057
DOI - 10.18027/2224-5057-2022-12-1-21-35
Subject(s) - topotecan , medicine , oncology , gemcitabine , platinum , ovarian cancer , meta analysis , carboplatin , etoposide , chemotherapy , confidence interval , regimen , cancer , cisplatin , biology , biochemistry , catalysis
Background : Recurrent ovarian cancer (OC) patients with platinum‑free interval (PFI) < 6 mo. are usually considered platinum‑resistant and treated with non‑platinum based chemotherapy. There is a lack of evidence to compare various non‑platinum therapeutic options in patients with platinum‑resistant ovarian cancer (PROC). We conducted meta‑analysis to assess efficacy of various therapeutic options in PROC patients. This article aimed to compare non‑platinum therapeutic regimens. Methods : We queried the PubMed database for full‑text articles and abstracts on the treatment of PROC patients (01/01/2000–01/06/2019 timeframe). Inclusion criteria were: 1) epithelial ovarian cancer; 2) recurrent disease ≤ 6 mo. after platinum‑based chemotherapy; 3) standard therapy with platinum‑ or non‑platinum agents; 4) no targeted therapy, investigational agents or non‑platinum doublets; 5) reported response rate (RR) and assessment criteria. Proportion meta‑analysis (random‑effect model) and beta‑regression were conducted to assess efficacy of various options. Statistical analysis was dose with meta and betareg packages of R software. Results : We identified 7156 articles and screened them for title and abstract, 157 studies were left for further analysis. Efficacy of non‑platinum‑ and platinum‑based therapy was assessed in 113 (n = 5272) and 44 (n = 1055) trials respectively, only the latter were included in this analysis. In meta‑proportion random‑ effect model RR among patients treated with taxanes, etoposide, doxorubicin/PLD, topotecan and gemcitabine were 27 % (95 % CI 0.21–0.34), 19 % (95 % ДИ 0.13–0.27), 15 % (95 % CI 0.11–0.19), 13 % (95 % CI 0.10–0.18) and 10 % (95 % CI 0.07–0.14), respectively. Multiple beta‑regression model accounting for response assessment method, number of prior therapy lines and other factors confirmed the results. Conclusions : Taxanes monotherapy may be the most effective therapeutic option for patients who are not candidates for platinum‑based chemotherapy.