Currently, researchers have found that neoadjuvant chemotherapy (NACT) which could enhance the stemness of ovarian cancer cells and induce platinum resistance gene mutations is an independent risk factor for platinum resistance. However, there is little data concerning the potential factors contributing to platinum resistance in patients receiving NACT. Herein, we conducted this real-world retrospective study to explore the factors associated with platinum resistance in NACT population.
Patients with histologically confirmed advanced ovarian cancer (IIIC-IV) who had received NACT at seven hospitals in China were enrolled from May 2004 to June 2020. Univariate and multivariate logistic regressions were performed with odds ratios (ORs) and 2-tailed 95% confidence intervals (CIs) to analyze the impacts of age, type, grade, stage, CA125 level, number of NACT cycles, and postoperative residual disease (R0, no macroscopic residual disease; R1, the maximum diameter of postoperative residual disease ≤ 1cm; R2, the maximum diameter of postoperative residual disease > 1cm) on platinum resistance. Statistical significance was considered at P < 0.05.
A total of 630 patients with stage IIIC-IV ovarian cancer who received NACT were included in the analysis. 316 (50.2%) patients received no more than two cycles of neoadjuvant chemotherapy. Patients with 1 or 2 NACT cycles had a lower rate of platinum resistance recurrence than patients with more than 2 NACT cycles (26.3% vs 35.4%, P = 0.017). In the univariate analyses, Stage IV and more than 2 NACT cycles were risk factors for platinum resistance (OR = 1.44, P = 0.039; OR = 1.54, P = 0.014). Besides, R1 and R2 were also risk factors for platinum resistance (OR = 1.61, P = 0.017; OR = 2.19, P = 0.001). In the multivariate logistic regression analyses, more than 2 NACT cycles was an independent risk factor for platinum resistance (OR = 1.79, P = 0.005). R1 and R2 were also independent risk factors for platinum resistance (OR = 2.00, P = 0.004; OR = 3.17, P < 0.001).
More than 2 cycles of NACT and residual disease were independent risk factors for platinum resistance in advanced ovarian cancer patients receiving neoadjuvant chemotherapy.
Tongji Hospital.
Has not received any funding.
All authors have declared no conflicts of interest.