Primary Platinum-Resistant Ovarian Cancer: Clinicopathologic Correlates and Outcomes From a Multicenter Prospective Indian Registry

PURPOSE To identify clinicopathologic factors associated with primary platinum-resistant ovarian cancer and evaluate survival outcomes using data from a multicenter, prospectively maintained Indian cancer registry. MATERIALS AND METHODS Data were analyzed from a prospective database of Network of Oncology Clinical Trials in India registry from six tertiary care centers between January 2022 and December 2023. Primary platinum-resistant ovarian cancer was defined as progression during treatment or recurrence within 6 months of completing initial platinum-based chemotherapy. Demographic, clinical, and treatment variables along with survival outcomes were evaluated. RESULTS Among 367 women with newly diagnosed epithelial ovarian cancer treated with platinum-based chemotherapy, 62 (16.9%) had primary platinum-resistant ovarian cancer. The cohort had a mean age of 54 ± 11.2 years, 79% were postmenopausal, and 53.2% had Eastern Cooperative Oncology Group performance score ≥2. High-grade serous carcinoma histology predominated (75.8%), 90.3% presented with stage III to IV disease, 74.2% had ascites, and 79.1% had peritoneal spread. Debulking surgery was performed in 24.2%, platinum-taxane doublet was used in 83.9%, and among those receiving curative intent treatment, 88.1% received chemotherapy in the neoadjuvant setting. Maintenance therapy was received by 6.5%; none entered clinical trials. Over a median follow-up of 10.32 months, median progression-free and overall survival were 4.75 (95% CI, 4 to 6) and 9.33 (95% CI, 6.2 to 16.3) months, respectively, from baseline at diagnosis. Primary platinum resistance was associated with poor performance status, ascites, advanced stage, omission of debulking surgery, neoadjuvant chemotherapy, and palliative-intent chemotherapy ( P < .05). CONCLUSION Primary platinum resistance affected 16.9% of Indian women with epithelial ovarian cancer and was linked to poor performance status, advanced stage, omission of debulking surgery, neoadjuvant chemotherapy, and dismal survival outcomes underscoring the urgent need for better predictive and therapeutic strategies.