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ESMO Gynae 2025 | Defining candidate patients with ovarian cancer for platinum treatment

Domenica Lorusso, MD, PhD, Fondazione IRCCS National Cancer Institute of Milan, Milan, Italy, comments on the evolving understanding of platinum sensitivity and resistance in endometrial cancer. Clinicians need to consider multiple factors beyond the platinum-free interval, including histotypes and progression during PARP inhibitors, which may lead to a reevaluation of the platinum paradigm. Antibody-drug conjugates (ADCs) additionally may have a potential role in this context. This interview took place at 2025 European Society for Medical Oncology (ESMO) Gynaecological Cancers Congress in Vienna, Austria.

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Transcript

Oh, that’s very important. Since several years, we consider only the platinum-free interval as the singular characteristic to define platinum-sensitive or platinum-resistant population. In reality, the situation is much more complex, and actually we consider a lot of other aspects, including histotypes, considering that four out of five histotypes of endometrial cancer are by definition platinum-resistant...

Oh, that’s very important. Since several years, we consider only the platinum-free interval as the singular characteristic to define platinum-sensitive or platinum-resistant population. In reality, the situation is much more complex, and actually we consider a lot of other aspects, including histotypes, considering that four out of five histotypes of endometrial cancer are by definition platinum-resistant. But also, we consider another aspect that is characterizing a new population, which is the patient progressing during PARP inhibitor. PARP inhibitor has been implemented in the maintenance setting in frontline ovarian cancer. They are very effective. They greatly increase progression-free and also overall survival. But unfortunately, the data we have suggests that patients progressing during PARP inhibitor are more resistant to platinum. So this is a new biological population. And during the symposium, we saw such interesting data with the ADC, single agent in patients progressing during PARP inhibitor. Data suggesting that probably for this patient the whole paradigm of platinum in platinum-sensitive versus platinum-resistant population probably should be changed and ADC play a specific role in this success.

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