Trabectedin plus pegylated liposomal doxorubicin in recurrent ovarian carcinoma after poly-ADP-ribose polymerase inhibitors progression: A real-world single-center experience

Background Platinum-based chemotherapy remains the cornerstone of treatment for recurrent ovarian cancer; however, optimal treatment sequencing after progression on PARP inhibitors (PARPi) remains uncertain, particularly in patients with partially platinum-sensitive disease. Objective to evaluate the efficacy, safety, and subsequent treatment patterns associated with trabectedin plus pegylated liposomal doxorubicin (PLD) in patients with recurrent ovarian cancer who had progressed after prior PARPi exposure. Methods This retrospective, single-center real-world study included patients with recurrent ovarian cancer, a platinum-free interval of 6–12 months, and progression after prior PARPi exposure. Results Twenty-five patients were included. The median age was 68.8 years, median platinum-free interval was 7.0 months, and patients had received a median of three prior lines of therapy. The objective response rate (ORR) was 24.0% and disease control rate (DCR) was 64.0%. Median progression-free survival (PFS) and overall survival (OS) were 7.9 and 19.9 months, respectively. Following progression on trabectedin plus PLD, 76.0% of patients received subsequent platinum-based chemotherapy, with an ORR of 33.3% among those receiving immediate platinum rechallenge. Toxicities were predominantly hematological, with no unexpected safety signals. Conclusions In this real-world, heavily pretreated post-PARPi population with partially platinum-sensitive disease, trabectedin plus PLD demonstrated clinically meaningful activity with an acceptable safety profile. In a setting where available evidence remains limited and heterogeneous, these findings provide additional clinically relevant data in a well-defined subgroup and support its use as a feasible treatment option in selected patients. Prospective studies are warranted to further define optimal treatment sequencing after PARPi exposure.