Dr. Konner on Preferred Platinum Doublets in Recurrent Ovarian Cancer

Jason A. Konner, MD
Published: Friday, May 17, 2019



Jason A. Konner, MD, medical oncologist, Memorial Sloan Kettering Cancer, discusses preferred platinum doublet chemotherapies in the treatment of patients with recurrent ovarian cancer.

The choice of which platinum doublet to give really needs to be individualized to the patient, says Konner. If a physician prefers to use bevacizumab (Avastin), it has to be incorporated into the patient’s course of treatment from the start. If a physician plans to use a PARP inhibitor for switch maintenance, the platinum doublet can be selected independent of that based on schedule and toxicity, prior treatments, and patient preference, he adds.

The first platinum doublet that showed a benefit was carboplatin and paclitaxel. It was encouraging to see something better than single-agent carboplatin, says Konner. However, patients had just grown their hair back. Their nerves were just recovering from frontline treatment with paclitaxel, so losing their hair again and getting more neuropathy was not desirable. Gemcitabine ushered in a welcome change, he adds. Moreover, the data from the phase III CALYPSO trial, showed that carboplatin and liposomal doxorubicin is as good as, and potentially better than, carboplatin/paclitaxel in that setting, which was very encouraging. As such, that has become one of Konner’s preferred regimens with regard to schedule, toxicity, and efficacy.
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Jason A. Konner, MD, medical oncologist, Memorial Sloan Kettering Cancer, discusses preferred platinum doublet chemotherapies in the treatment of patients with recurrent ovarian cancer.

The choice of which platinum doublet to give really needs to be individualized to the patient, says Konner. If a physician prefers to use bevacizumab (Avastin), it has to be incorporated into the patient’s course of treatment from the start. If a physician plans to use a PARP inhibitor for switch maintenance, the platinum doublet can be selected independent of that based on schedule and toxicity, prior treatments, and patient preference, he adds.

The first platinum doublet that showed a benefit was carboplatin and paclitaxel. It was encouraging to see something better than single-agent carboplatin, says Konner. However, patients had just grown their hair back. Their nerves were just recovering from frontline treatment with paclitaxel, so losing their hair again and getting more neuropathy was not desirable. Gemcitabine ushered in a welcome change, he adds. Moreover, the data from the phase III CALYPSO trial, showed that carboplatin and liposomal doxorubicin is as good as, and potentially better than, carboplatin/paclitaxel in that setting, which was very encouraging. As such, that has become one of Konner’s preferred regimens with regard to schedule, toxicity, and efficacy.



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