Understanding platinum-resistant ovarian cancer, the options that may be available and how treatment decisions are made will help you have more informed conversations with your care team.
"Treatment for platinum-resistant ovarian cancer is highly personalized," says Josephine Kim, M.D., a gynecologic oncologist at City of Hope Orange County and an assistant clinical professor of gynecologic oncology at City of Hope. "Every patient is a unique individual with unique needs, and what comes next depends on factors such as the tumor's biology, prior treatments and how well they were tolerated, how quickly the cancer is progressing, and the patient's goals and preferences."
In this article, you'll learn about:
- What platinum resistance means for treatment
- Treatment options that may be available
- How antibody-drug conjugates work
- Managing treatment side effects
- The role of clinical trials
What platinum resistance means for treatment
Standard platinum-based chemotherapy is often the first treatment for ovarian cancer. These drugs damage cancer cell DNA, making it harder for the cells to grow and divide.
Because every patient's cancer and body is different, there isn't a single treatment sequence that's equally effective for everyone.
If the cancer continues to grow during treatment or returns within about six months after platinum-based chemotherapy, it is considered platinum-resistant. At that point, the care team begins looking at treatments that may be more effective for the patient’s individual situation.
They consider factors such as the tumor's biology, previous treatments, how well they were tolerated, how quickly the cancer is progressing, and your goals and preferences.
Treatment options
Treatment options continue to expand and may include non-platinum chemotherapy, targeted therapies, immunotherapy or combinations of these approaches.
An example of combination therapy is utilization of the immunotherapy drug pembrolizumab (Keytruda®) with the chemotherapy paclitaxel, with or without bevacizumab (Avastin®), for certain patients with platinum-resistant ovarian cancer.
These treatments work in different ways. Pembrolizumab helps the immune system recognize and fight cancer, paclitaxel directly kills cancer cells, and bevacizumab, when used, helps limit the tumor's blood supply. This combination may be appropriate for certain patients whose tumors express PD-L1 and who have already received prior treatment.
Patients interested in learning whether there or any other treatments may be appropriate for them should speak with their physician or schedule a consultation with a City of Hope specialist.
How ADCs work
Antibody-drug conjugates (ADCs) are innovative cancer treatments that combine targeted therapy with a cancer-killing drug. They can deliver chemotherapy more directly to specific cancer cells while limiting exposure to healthy tissue.
For example, mirvetuximab soravtansine (Elahere®), targets a protein called folate receptor alpha (FRα) found on some ovarian cancer cells. It is typically used for patients with FRα-positive, platinum-resistant ovarian cancer who have already received prior treatment. Clinical studies have shown improved outcomes compared with standard chemotherapy in appropriately selected patients.
Managing treatment side effects
The side effects reflect each part of the treatment, and many can be managed when recognized early. They may include fatigue, hair loss, low blood counts, numbness or tingling in the hands and feet, high blood pressure or immune-related inflammation.
Patients receiving mirvetuximab soravtansine also require regular eye exams because the medication can cause blurred vision, dry eyes and light sensitivity. Preventive eye drops are typically part of treatment.
Always let your care team know about new or worsening symptoms as soon as possible. Early communication can help prevent side effects from becoming more serious.
The role of clinical trials
Clinical trials are an important part of advancing new therapies for platinum-resistant ovarian cancer. They help researchers better understand which treatments work best, who is most likely to benefit and how to manage side effects. Participating in a clinical trial may provide access to promising therapies before they become widely available while helping improve future care.
Patients at City of Hope have access to more than 700 innovative Phase 1 to 3 clinical trials, including groundbreaking first-in-human trials and complex trials requiring inpatient care — more than anywhere else in California.
The most advanced gynecologic oncology and specialty care in Orange County
City of Hope offers Orange County’s most advanced and comprehensive program for gynecologic oncology and urogynecologic care. The program offers a broad range of expertise in cancer treatment, complex non-cancerous gynecologic disorders, urogynecology and pelvic floor dysfunction.
Patients have access to the latest in prevention, diagnosis, treatment, innovative Phase 1-3 clinical trials, and survivorship care — all of which provide the greatest hope for recovery and quality of life.
Ending Cancer Starts with Hope. To make an appointment at any of City of Hope’s Orange County locations, call 888-333-HOPE (4673).
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