Patients whose tumors were assay-resistant to carboplatin had an increased risk of early GDC0068 disease progression, as compared to those whose assay results were nonresistant for carboplatin, recurring on average 5 months sooner. Furthermore, based on the Kaplan-Meier plot of the current study (Figure 2), within 6 months of the start of chemotherapy, 25% of assay-resistant patients had already recurred, while <10% of assay-sensitive (nonresistant) had recurred. Likewise, at

18 months after the start of chemotherapy, approximately 50% of assay-sensitive patients had been free of disease progression, while 80% of assay-resistant patients had recurred. Multivariate analysis of assay results for paclitaxel demonstrated a positive trend, and, further, patients who were resistant to both agents demonstrated the worst outcomes, which was significantly different from patients nonresistant to both agents. These results are consistent with the notion that the platinum portion of the standard regimen for advanced-stage EOC plays the larger role in the clinical performance of that regimen.18 and 19 As such, it is expected that assay results

for paclitaxel are not as highly correlated with PFS as are those for carboplatin and carboplatin + paclitaxel. OS will be included in future analyses. The ability of this assay to identify patients likely to be platinum resistant creates the

opportunity to consider alternate treatments regimens for these patients earlier selleck screening library in the course of treatment. Alternate treatments may be considered either initially following surgery or upon first clinical indication of suboptimal performance during standard first-line treatment. Earlier intervention may allow for a reduction in toxicities incurred by the patient from ineffective therapy, as well as a reduction in the overall costs of treatment.20 Most importantly, assay-informed treatment decisions may lead to others earlier treatment with a more effective therapy, thereby delaying recurrence and potentially lengthening the overall expected survival duration for these high-risk patients. Identification of advanced-stage EOC patients as platinum resistant prior to treatment could inform first-line treatment decisions in a variety of ways, including substitution of alternate active agents, alteration of the planned first-line therapy to a dose-dense approach, or the addition of novel therapies that may overcome the resistance observed.5, 6, 7, 21, 22 and 23 Results from various completed and ongoing studies investigating alternate treatment strategies to carboplatin + paclitaxel should be referenced when considering treatment different than carboplatin + paclitaxel.