The optimal choice of chemotherapy regimens for patients with relapsed platinum-resistant epithelial ovarian cancer/primary peritoneal/fallopian tube cancer — protocol for a systematic review and network meta-analysis

Background: Debulking surgery (residual disease of less than 1 cm) followed by platinum-taxane chemotherapy is the current standard therapy for patients with epithelial ovarian cancer, primary peritoneal carcinoma and primary fallopian cancer. But the prognosis remains poor. Several chemotherapy regimens could be selected for patients with recrudescent cancer. However, the standard second chemotherapy regimen remains a subject of debate. The purpose of our study is to carry out a systematic review and network meta-analysis to compare the efficacy and safety of different regimens for recurrent platinum-resistant ovarian cancer based on existing randomized controlled trials (RCTs). Methods and analysis: Medline, EMBASE, Cochrane Library and Cochrane Library databases, Science Citation Index Expanded, Conference Proceedings Citation Index-Science and ClinicalTrials.gov will be systematically searched for eligible studies. Randomized controlled trials (RCT) on chemotherapy, immune therapy, biological therapy, targeted therapy for recurrent platinum-resistant ovarian cancer with multiple outcome measures will be included. The Cochrane Risk of Bias Tool will be used to assess the quality of included studies. The primary outcomes are overall survival and median survival time. The secondary outcomes include the safety and side effects of these regimens. Direct meta-analysis and network meta-analysis (NMA) will be conducted to compare different regimens. Conclusion: The results of this network meta-analysis will provide direct and indirect evidence of treatments for recurrent platinum-resistant ovarian cancer, and it may provide a ranking of the chemotherapy regimens for patients and gynecological oncologists to help them select the best option