Efficacy of Platinum-based Chemotherapy in Platinum-resistant Ovarian Cancer) (EPITOC)

Inclusion Criteria:

• Age 18-70 years;

• Histologically confirmed epithelial ovarian cancer (excluding mucinous, clear-cell andlow-grade subtypes);

• Ovarian cancer recurrence within 3-6 months after completion of platinum-basedchemotherapy (given to possible variability in follow-up practices and tumor growthkinetics patients with platinum-free interval ≥3 and <7 months will be consideredplatinum-resistant);

• Platinum-free interval ≤12 months;

• Eastern Cooperative Oncology Group (ECOG) performance status ≤2;

• Response to penultimate platinum-based chemotherapy defined as partial or completeresponse assessed by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1criteria or ≥50% reduction in CA-125 concentration for patients without measurablelesions;

• Not refractory to penultimate platinum-based chemotherapy regimen (ie, the disease didnot progress during platinum-based chemotherapy and within ≤3 months after itscompletion);

• Patients received ≤3 lines of prior chemotherapy;

• No central nervous system (CNS) metastatic involvement;

• No severe and uncontrolled concomitant diseases;

• Adequate organ function:

• Bone marrow - hemoglobin ≥ 90 g/l; Neutrophils ≥1,5x109/l; Platelets ≥75x109/l);

• Renal - estimated creatinine clearance ≥50 ml/min (determined by Cockcroft-Gaultequation);

• Hepatic - alanine aminotransferase (ALaT) & aspartate transaminase (ASaT) ≤3upper limit of normal (ULN), total bilirubin ≤ 25 umol/l;

• Known BRCA1/2 mutation status as it will be used for stratification;

• Life expectancy >3 months;

• Patient is willingly consent to participate in the trial and signed informed consentform

Exclusion Criteria:

• Platinum-refractory ovarian cancer defined as disease progression during penultimateplatinum-based chemotherapy or ≤3 month after its completion;

• No response to penultimate platinum-based chemotherapy;

• Mucinous, clear-cell or low-grade serous/endometrioid histology;

• >3 lines of prior therapy lines for advanced ovarian cancer (prior maintenanceendocrine therapy or poly ADP ribose polymerase (PARP) inhibitors is allowed);

• Prior therapy with PARP-inhibitors and endocrine therapy as a treatment forprogressive ovarian cancer;

• Platinum-free interval >12 months;

• Symptoms of bowel obstruction of any etiology;

• Contraindications to platinum-based chemotherapy;

• Planned administration of PARP inhibitors during or after this line of chemotherapy;

• Life expectancy <3 months;

• Uncontrolled and/or severe concomitant diseases (eg, uncontrolled diabetes mellitus,renal failure, hepatic failure, uncontrolled arterial hypertension, arrhythmia, heartfailure);

• Metastatic CNS involvement;

• Neuropathy grade >2.