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Background <p>Platinum-resistant ovarian cancer (OC) presents a significant therapeutic challenge with limited effective salvage options and dismal survival outcomes. Utidelone (UTD1), a novel synthetic epothilone B analogue that circumvents P-glycoprotein-mediated drug efflux, demonstrates preclinical efficacy against multidrug-resistant malignancies through β-tubulin binding mechanisms distinct from conventional taxanes. However, clinical evidence supporting its application in platinum-resistant high-grade serous ovarian cancer (HGSOC) remains limited.</p> Case presentation <p>A 45-year-old woman with recurrent HGSOC underwent multiple sequential therapeutic interventions, including primary cytoreductive surgery, platinum-based chemotherapy, anti-angiogenic therapy, and targeted agents. Following disease progression on fourth-line treatment characterized by symptomatic peritoneal carcinomatosis and rising tumor markers, UTD1 monotherapy (40&#xa0;mg/m² daily on days 1–5 every 21 days) was initiated. Treatment resulted in rapid symptomatic palliation, substantial biochemical response (50.8% reduction in CA-125 levels), and radiographic partial response (30% reduction in target lesions by RECIST 1.1 criteria). Progression-free survival reached 7 months with manageable toxicity (grade 2 sensory neuropathy, grade 2 gastrointestinal symptoms) despite extensive prior exposure to neurotoxic agents.</p> Conclusion <p>This index case provides additional evidence supporting UTD1’s clinical activity in platinum-resistant HGSOC, with meaningful therapeutic efficacy and favorable hematologic toxicity profile in a heavily pretreated setting. The observed clinical benefit substantiates UTD1’s unique pharmacologic properties in potentially overcoming taxane/platinum cross-resistance mechanisms. Prospective investigations with comprehensive pharmacodynamic biomarker assessment are warranted to further characterize UTD1’s role in platinum-resistant ovarian cancer treatment paradigms.</p>

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Utidelone monotherapy suggesting clinical efficacy in heavily pretreated platinum-resistant high-grade serous ovarian cancer: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月20日

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  • Feifei Kong,
  • Ying Gao,
  • Lianzi Wei,
  • Meng Yang,
  • Haixia Shan

摘要

Background

Platinum-resistant ovarian cancer (OC) presents a significant therapeutic challenge with limited effective salvage options and dismal survival outcomes. Utidelone (UTD1), a novel synthetic epothilone B analogue that circumvents P-glycoprotein-mediated drug efflux, demonstrates preclinical efficacy against multidrug-resistant malignancies through β-tubulin binding mechanisms distinct from conventional taxanes. However, clinical evidence supporting its application in platinum-resistant high-grade serous ovarian cancer (HGSOC) remains limited.

Case presentation

A 45-year-old woman with recurrent HGSOC underwent multiple sequential therapeutic interventions, including primary cytoreductive surgery, platinum-based chemotherapy, anti-angiogenic therapy, and targeted agents. Following disease progression on fourth-line treatment characterized by symptomatic peritoneal carcinomatosis and rising tumor markers, UTD1 monotherapy (40 mg/m² daily on days 1–5 every 21 days) was initiated. Treatment resulted in rapid symptomatic palliation, substantial biochemical response (50.8% reduction in CA-125 levels), and radiographic partial response (30% reduction in target lesions by RECIST 1.1 criteria). Progression-free survival reached 7 months with manageable toxicity (grade 2 sensory neuropathy, grade 2 gastrointestinal symptoms) despite extensive prior exposure to neurotoxic agents.

Conclusion

This index case provides additional evidence supporting UTD1’s clinical activity in platinum-resistant HGSOC, with meaningful therapeutic efficacy and favorable hematologic toxicity profile in a heavily pretreated setting. The observed clinical benefit substantiates UTD1’s unique pharmacologic properties in potentially overcoming taxane/platinum cross-resistance mechanisms. Prospective investigations with comprehensive pharmacodynamic biomarker assessment are warranted to further characterize UTD1’s role in platinum-resistant ovarian cancer treatment paradigms.