INOVATYON/ ENGOT-ov5 study: Randomized phase III international study comparing trabectedin/pegylated liposomal doxorubicin (PLD) followed by platinum at progression vs carboplatin/PLD in patients with recurrent ovarian cancer progressing within 6-12 months after last platinum line.

BACKGROUND: This trial investigated the hypothesis that the treatment with trabectedin/PLD (TP) to extend the platinum-free interval (TFIp) can improve overall survival (OS) in patients with recurrent ovarian cancer (OC). METHODS: Patients with OC (up to two previous platinum-based lines), with a TFIp of 6-12 months, were randomised to receive carboplatin/PLD (CP) or TP followed by platinum therapy at relapse. The primary endpoint was OS (HR: 0.75). RESULTS: The study enrolled 617 patients. The median TFIp was 8.3 months and 30.3% of patients had received two previous platinum lines. 74% and 73.9% of patients, respectively, received a subsequent therapy (ST) in the CP and TP arm; in the latter TP arm 87.2% of ST was platinum-based, as per protocol. The median OS was 21.4 for CP and 21.9 months for TP (HR 1.13; 95% CI: 0.94-1.35; p = 0.197). Grade 3-5 adverse reactions occurred in 37.1% of patients in the CP arm and 69.7% of patients in the TP arm, and the most frequent were neutropenia (22.8% CP, 39.5% TP), gastrointestinal (7.1% CP, 17.4% TP), hepatic (0.7% CP, 19.1% TP). CONCLUSIONS: This study did not meet the primary endpoint. CP combination remains the standard for patients with recurrent OC and a 6-12 months TFIp; TP is an effective treatment in patients suffering from persistent platinum toxicities. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, number NCT01379989.

Hipersensibilidad al carboplatino / Hypersensitivity reactions to Carboplatin

Propósito: Descripción de las características clínicas de la hipersensibilidad al Carboplatino (CBDCA).Material y métodos: Presentamos cuatro casos de hipersensibilidad al CBDCA recogidos a lo largo de 14 meses entre 143 pacientes tratados con esta medicación. Resultados: Todas habían recibido tratamiento previo con CBDCA sin problemas y la reacción apareció tras uno o más ciclos. Todas presentaron ansiedad, tres prurito, una exantema, otra eritema, una tos, otra disnea, otra hipotensión y otra dolor torácico. En dos de ellas inicialmente la reacción se achacó al paclitaxel. Conclusión: Una reacción alérgica al CBDCA puede comprometer la vida del paciente por lo que es importante conocer los signos y síntomas de la misma para tratarla y evitar reexposiciones graves (AU)