Ovarian Cancer

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Fighting “Platinum Resistant” Ovarian Cancer

Dr. Bobbie Rimel Cedars-Sinai Medical Center

Chemotherapy is one of the most potent tools for fighting ovarian cancer, but sometimes the cancer proves stubbornly resistant to the most popular chemo drugs. In these cases, however, there are other options for treatment.

What is a “Platinum Resistant” Tumor?

A cancer that comes back within six months of treatment with a platinum-based chemotherapy drug is called “platinum resistant”. If a cancer returns after 6 months following platinum-based chemotherapy is complete, it’s called “platinum sensitive,” and is considered easier to treat.

Patients can start off with “platinum sensitive” tumors, but after multiple recurrences, may at some point become “platinum resistant.” Other women start off initially with platinum resistant tumors. And while platinum resistant tumors are traditionally harder to treat than regular ovarian cancer tumors, there are still options.

A platinum resistant tumor is not a reason to give up hope, says Dr. BJ Rimel, gynecologic oncologist at Cedars-Sinai Medical Center. It does mean that there are less available drugs to use, although that is changing every minute.

Options For Women With Platinum Resistant Tumors

Rimel says that a woman who is dealing with platinum resistant ovarian cancer should start by having a very frank conversation with her doctor about what the options that are available to her for treatment and what her goals should be with that treatment.

The patient with platinum resistant ovarian cancer has options for chemotherapy, with or without bevacizumab (aka Avastin), that patient may also choose to be a part of a clinical trial, whether that clinical trial uses immunotherapy or other novel agents, a patient with platinum disease may also be on bevacizumab long term for reduction in the amount of tumor she has. There are lots of different options.

There are some studies looking at platinum resistant patients with PARP inhibitors and data suggests there is a small population of patients that will benefit from that PARP inhibitor.

However, Rimel says that right now, doctors and researchers are unclear about who those patients are exactly, so they aren’t sure how widespread the benefit would be from that kind of treatment.

There are published studies that say that agents like bevacizumab (Avastin) can be particularly useful in combined therapy such as a studied published on PubMed.gov as a part of the US National Library of Medicine at the National Institutes of Health.

This combination had been used in several different clinical trials in the past. Clinical trials are important for the advancement of treatment options for women with ovarian cancer. The National Ovarian Cancer Coalition offers a listing of outside resources for clinical trials. Their page includes a list of clinical trial sites as well as resources for caregiver support.

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Dr. Bobbie J. Rimel is an OB/GYN and Oncologist at Cedars-Sinai Medical Center. Read More

Ovarian Cancer Recurrence

Most ovarian cancers that are treated will recur after a period of remission. Sometimes the cancer can go into remission again, then return repeatedly. Once her cancer returns, a woman will discuss with her doctor various options for new treatment, which include more rounds of chemotherapy, PARP inhibitors and participation in clinical trials.