Efficacy and safety of trabectedin and pegylated liposomal doxorubicin in elderly patients: a subgroup analysis of a retrospective cohort

Elderly patients with recurrent ovarian cancer are often underrepresented in clinical trials, complicating treatment decisions because of comorbidities and altered drug tolerance. Trabectedin plus pegylated liposomal doxorubicin is a non-platinum option for patients with a platinum-free interval of 6-12 months. This single-center retrospective study evaluated the efficacy and safety of this combination in 23 patients aged ≥65 years with partially platinum-sensitive relapsed ovarian cancer treated between 2018 and 2022. Median age was 68 years. The median progression-free survival was 6 months (95% CI: 4-9), and the median overall survival was 18 months (95% CI: 12-101). Treatment was generally well tolerated, with mostly grade 1-2 hematologic toxicities, particularly anemia and neutropenia, and no treatment-related deaths. These findings suggest that trabectedin plus pegylated liposomal doxorubicin has clinically meaningful activity and an acceptable safety profile in this elderly population, although confirmation in larger cohorts is needed.