BRCA Status May Help Guide Platinum Rechallenge in Ovarian Cancer
By: Wendy LaGrego
Posted: Friday, September 11, 2026
Platinum rechallenge may provide clinical benefit for selected patients with platinum-resistant ovarian cancer, particularly those with BRCA1/2-mutated tumors, according to a study published in Cancers. David García-Illescas, MD, of the Gynaecologic Cancer Programme, Medical Oncology Department, Vall d’Hebron Institute of Oncology and Hospital Universitari Vall d’Hebron, Barcelona, and colleagues conducted a study to assess the clinical benefit and safety of platinum rechallenge after an extended interval of nonplatinum therapy and to explore BRCA mutation status as a potential predictive biomarker.
Study Details
The retrospective, observational study included 63 patients with platinum-resistant ovarian cancer who underwent platinum rechallenge at Vall d’Hebron University Hospital between January 2010 and July 2023. Platinum resistance was defined as disease progression within 6 months of the last platinum dose. Eligible patients had received at least one intervening nonplatinum regimen and had an interval of at least 12 months between their last platinum dose and rechallenge. Patients with primary platinum-refractory disease were excluded. The primary outcome was objective response rate according to Response Evaluation Criteria in Solid Tumors version 1.1; additional outcomes included progression-free survival, overall survival, platinum-free interval after rechallenge, and safety.
The median patient age was 57 years (interquartile range [IQR] = 47–63 years), and 97% had an Eastern Cooperative Oncology Group performance status of 0 or 1. Most patients (92%) had high-grade serous disease, and the median number of previous treatment lines was six. Prior PARP inhibitor therapy had been administered to 46% of patients, and the median platinum-free interval before rechallenge was 25 months (IQR = 20–33 months). Thirteen patients (20%) had BRCA1/2-mutated tumors, 46 (73%) had BRCA wild-type tumors, and 4 (6%) had unknown BRCA status.
Key Findings
The objective response rate with platinum rechallenge was 57.1% (95% confidence interval [CI] = 42.1%–73.0%), including 2 complete and 34 partial responses. An additional 17 patients (27%) achieved stable disease, yielding a disease control rate of 84.1%. The objective response rate was 76.9% among patients with BRCA1/2-mutated tumors compared with 50.0% among those with BRCA wild-type tumors.
Median progression-free survival was 7.3 months overall. It was longer among patients with BRCA-mutated vs BRCA wild-type tumors (8.44 vs 7.44 months; hazard ratio [HR] = 0.47, 95% CI = 0.23–0.94; P = .033). In an exploratory analysis, patients with BRCA-mutated tumors who had received four or fewer prior lines of treatment had a median progression-free survival of 12.3 months.
Median overall survival was 15.84 months in the entire cohort and 31.93 vs 15.84 months in the BRCA-mutated and BRCA wild-type groups, respectively (HR = 0.63, 95% CI = 0.31–1.28; P = .204). A platinum-free interval of at least 6 months after rechallenge was achieved by 38.5% of patients with BRCA-mutated tumors and 13.0% of those with BRCA wild-type tumors.
The most common grade ≥ 3 adverse events were neutropenia (43%), anemia (13%), and thrombocytopenia (11%); no grade 5 events occurred, and no adverse events resulted in treatment discontinuation.
“These findings suggest that BRCA status, together with clinical selection factors such as prolonged interval since prior platinum treatment and number of prior treatment lines, may help identify patients for whom platinum rechallenge remains a reasonable therapeutic option,” the authors concluded.
DISCLOSURE: For full disclosures of the study authors, visit mdpi.com.
