Need for new therapies
Although OC is one of the most chemotherapy-sensitive malignancies, as previously discussed, mortality rates remain high. Most patients with advanced disease receive chemotherapy, but eventually relapse and will need further treatment.
Unlike primary therapy, treatment options are particularly limited for patients with platinum-resistant disease, and for patients with platinum-sensitive disease in whom platinum-based agents are no longer an option due to toxic sequelae, such as neurotoxicity, cumulative thrombocytopenia, hypersensitivity reactions or ototoxicity [Fung-Kee-Fung 2007; Pignata 2000].
Preclinical and clinical data indicate that extending the platinum-free interval (PFI) in recurrent ovarian cancer after relapse by using an alternative non-platinum based chemotherapy regimen may increase the efficacy of a subsequent platinum re-challenge in patients with platinum-sensitive disease [Bookman 1999; Kavanagh 1995; Poveda 2010].
The artificial extension of PFI with an intervening non-platinum therapy may be beneficial possibly by reversing platinum resistance, which may be of particular interest to patients with partially platinum-sensitive disease (PFI 6-12 months) [Poveda 2010].
No standard treatment has been defined for the intermediate population presenting partially sensitive disease, defined by a progression-free interval between 6-12 months.
The identification of efficacious non-platinum based combinations is important in ROC. Yondelis® emerges in response to the continued need for the development of effective agents in the management of ROC.