Restoring platinum sensitivity in recurrent ovarian cancer by extending the platinum‐free interval: Myth or reality?

The platinum‐free interval is the most important predictive factor of a response to subsequent lines of chemotherapy and the most important prognostic factor for progression‐free and overall survival in patients with recurrent epithelial ovarian cancer. A nonplatinum regimen is generally considered the most appropriate approach when the disease recurs very early after the end of chemotherapy, whereas platinum‐based chemotherapy is usually adopted when the platinum‐free interval exceeds 12 months. However, the therapeutic management of patients with intermediate sensitivity (ie, when the relapse occurs between 6 and 12 months) remains debatable. Preclinical and clinical data suggest that the extension of platinum‐free interval (using a nonplatinum‐based regimen) might restore platinum sensitivity, thus allowing survival improvement. The objective of this review was to critically analyze preclinical and clinical evidences supporting this hypothesis. Cancer 2017;123:3450‐9. © 2017 American Cancer Society .