Platinum-sensitive ovarian relapse — Platinum-Free Interval (PFI) >6 months from last pla...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-OVARIAN-PLATINUM-SENSITIVE`
Type	Red flag
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	`DIS-OVARIAN`
Sources	`SRC-ESMO-OVARIAN-2024` `SRC-GOG0213-COLEMAN-2017` `SRC-NCCN-OVARIAN-2025` `SRC-OCEANS-AGHAJANIAN-2012`

Red Flag Origin

Definition	Platinum-sensitive ovarian relapse — Platinum-Free Interval (PFI) >6 months from last platinum dose to recurrence. Treatment-defining: re-platinum doublet (carbo + paclitaxel/PLD/gem) ± bevacizumab maintenance. PARPi maintenance after response if HRD-positive.
Clinical direction	intensify
Category	transformation-progression
Shifts algorithm	ALGO-OVARIAN-2L

Trigger Logic

{
  "any_of": [
    {
      "comparator": ">",
      "finding": "platinum_free_interval_months",
      "threshold": 6
    },
    {
      "finding": "platinum_status",
      "value": "sensitive"
    }
  ],
  "type": "composite_score"
}

Notes

PFI 6-12 mo (partially platinum-sensitive) and >12 mo (fully platinum-sensitive) historically distinguished — both candidates for re-platinum, but >12 mo has higher response rates. ESMO 2024 has moved toward biology-driven decisions (HRD/BRCA + symptom burden) rather than rigid PFI threshold. OCEANS / GOG-0213 — platinum + chemo + bev superior to platinum + chemo alone (OS in GOG-0213 with weekly paclitaxel arm). PARPi maintenance after platinum response in HRD-positive: olaparib (SOLO-2), niraparib (NOVA), rucaparib (ARIEL3).

Used By

Algorithms

ALGO-OVARIAN-2L - ALGO-OVARIAN-2L