Introduction/Background*Weekly Cisplatin plus oral daily Etoposide (the Rotterdam regime (RR), 2002) has been shown to be effective in platinum refractory (PR) ovarian cancer (OC), with a documented response rate of 46%, with 29% complete response and overall survival (OS) of 13 months¹. The RR is schedule intensive and can be difficult to tolerate, therefore may be underutilised as an option for patients with PR OC who have maintained a good performance status (PS). We are reporting our series of patients undergoing the RR with regards to efficacy and tolerability.

Methodology Retrospective case series (n=13) with PR OC, and still fit (PS < 2), who have previously been treated with multiple chemotherapy lines were assessed for tolerability, response and subsequent reversal back to platinum-sensitivity (P-S).

Result(s)*Ten had serous, 2 had clear cell carcinoma and 1 had carcinosarcoma of OC. The patients were heavily pre-treated, with 15% 3^rd line, 55% 4^th line, 25% 5^th line, and 5% 7^th line cancer treatment. Five women have died of OC, all within one year of starting the RR. Three patients have been converted back to P-S disease post-RR (23%), with one patient now alive 5 years after completing the RR. Of the remaining 5 women: Re-challenge with platinum (n=2); referred for a clinical trial (n=1), awaiting surgery for single site disease (n=1); still on the RR (n=1).

Nausea and tiredness were the main side effects affecting 80% of all patients in their first 6 weeks. The RR had an improvised protocol with 4 antiemetics, and Magnesium sachet supplement. More than 70% had low Magnesium; and required supplement up to 5 weeks from completion of the last Infusion of Cisplatin. Tiredness was common and linked to low moods, which led to us setting up a ‘buddy-system’ for those about to embark on RR.

Conclusion*The RR converted 23% of PR OC back to P-S, with further results awaited. One patient is now in her sixth-year post-RR and has continued to have P-S disease. Despite significant side effects nearly half of patients maintained a PS<2, therefore we advise consideration of using the RR in PR disease.