Introduction/Background Oxaliplatin, in the era prior to antiangiogenics and PARPi therapies, demonstrated activity in patients (pts) with ovarian cancer (OC) in phase I, II and III studies. Oxaliplatin may play a role in pts with hypersensitivity reactions (HRs) to carboplatin.

Methodology Single-institution retrospective experience (2004–2022) in terms of efficacy and safety with oxaliplatin in recurrent OC, especially in pts with HRs to carboplatin.SPSS version 22.0 was used for statistical analyses

Results 68 pts were treated with oxaliplatin (monotherapy, 25%, in combination 75%, mostly with gemcitabine (56.4%) or paclitaxel (15,1%). Pts and disease characteristics are shown in Table 1. Median progression free survival (mPFS) and overall survival (mOS) were 3 and 13 months (m), respectively. There was no difference between platinum-resistant and platinum-sensitive in terms of PFS, but there was a benefit in mOS in platinum-sensitive disease (13 vs 6 m). Pts who attained controlled disease with oxaliplatin showed a mPFS of 6 months and mOS of 15 months. 45.9% of patients had experienced prior HRs to carboplatin; 67% of them did not require desensitization to oxaliplatin. However, 17.8% of the patients suffered HRs to oxaliplatin. PARPi before oxaliplatin was used in 5 pts. Of them, two stable diseases were achieved with no objective responses. Pts with clinical benefit to oxaliplatin and who had received prior bevacizumab had a 64% lower risk of progression (HR 0.36 IC 95% 0.169–0.800,p 0.012), and patients with no benefit from oxaliplatin had a better outcome with the previous use of bevacizumab (HR 0.20, IC 95% 0.064 – 0.679,p=0.009). Grade 3/4 toxicity was observed in 36.8%, mainly hematological and gastrointestinal toxicity.

Conclusion Oxaliplatin improves PFS and OS in pts with OC recurrent setting, in particular in those pts not candidates to receive carboplatin-based regimens mainly due to HRs. Oxaliplatin is currently a valid treatment.