Do Patients With Platinum-Resistant Epithelial Ovarian Cancer Benefit From Second-line Chemotherapy?

Background: The survival benefit of second-line chemotherapy in the treatment of patients with platinum-resistant epithelial ovarian cancer has not yet been established. It is unclear whether these patients may benefit from second-line chemotherapy. Patients and Methods: This study included 51 consecutive patients with platinum-resistant cancer (interval between last chemotherapy cycle and detection of tumor recurrence or progressive disease < 6 months) who died between 1999 and 2008 at the National Cancer Center Hospital. To identify the factors associated with longer survival in such patients, the Cox proportional hazard model was used to perform multivariate analyses of factors influencing patient survival, including performance status (PS) and second-line chemotherapy. Results: In patients with platinum-resistant disease, the median progression-free interval from the last cycle of first-line chemotherapy to the time of detection of progressive disease was 46 days (range, 5-169 days); the median survival time after the detection of progressive disease was 5.6 months (range, 0.3-69.8 months). Patients who received second-line chemotherapy had significantly longer survival times than those who did not (6.3 months vs. 3.1 months; P = .0039). However, multivariate analyses revealed that PS was the only factor associated with survival (hazard ratio [HR], 0.267; 95% CI, 0.114-0.626; P < .0024). Exposure to second-line chemotherapy was not associated with survival (HR, 0.488; 95% CI, 0.3-2.0; P = .103). Conclusion: Good PS (< 2; not second-line chemotherapy) is the only factor associated with longer survival in patients with platinum-resistant ovarian cancer. Patients with a poor PS status (≥ 2) may not benefit from second-line chemotherapy.