Dr Moore on the Evolving Treatment Landscape for Platinum-Resistant Ovarian Cancer

Kathleen N. Moore, MD, MS, professor, Section of Gynecologic Oncology, associate director, Clinical Research, Stephenson Cancer Center, director, Oklahoma TSET Phase I Program, University of Oklahoma College of Medicine, The University of Oklahoma Health Sciences, discusses the evolving treatment landscape for patients with platinum-resistant ovarian cancer, emphasizing the importance of redefining resistance parameters to guide treatment decisions more effectively.

Although there have been some recent shifts within this treatment paradigm, ongoing research and anticipated data could soon refine management of platinum-resistant ovarian cancer, Moore begins.

First, the definition of platinum resistance is undergoing an evolution, Moore explains. Traditionally, platinum-resistant ovarian cancer has been defined as disease progression within 6 months of the last dose of a platinum-based therapy, Moore explains, noting that this definition remains a regulatory standard. However, emerging insights suggest that this 6-month benchmark may not capture the full spectrum of tumors that could be considered platinum-resistant, she says.

For example, Moore highlights that patients who do not respond to platinum-based therapy and then undergo maintenance therapy with an agent such as bevacizumab (Avastin) for a number of months may not have tumors that should be considered platinum-sensitive. Nuances such as this or an allergy to platinum-based therapy could help better define platinum-resistant disease, she adds.

Moore notes that tumors that progress during or after maintenance with PARP inhibitors also present a unique challenge. These patients are often said to have platinum-sensitive disease, based on the time elapsed since the last platinum regimen; however, evidence suggests they may exhibit a reduced response to subsequent platinum-based therapies, Moore continues. Although these tumors may not be fully resistant to platinum-based therapies, they demonstrate less robust sensitivity than previously believed, further complicating treatment choices.

Looking forward, Moore anticipates that new clinical trial data will expand understanding and refine treatment pathways for these diverse groups within the platinum-resistant spectrum. The evolving definitions are expected to better categorize patients who may benefit from non-platinum regimens, including newer therapies currently under investigation.

The changing definition of platinum resistance will likely enhance therapeutic selection and optimize outcomes for patients with ovarian cancer, and future research will help clarify these distinctions, paving the way for more personalized approaches outcomes quality of life for patients with platinum-resistant ovarian cancer, Moore concludes.