scholarly journals Treatment of epithelial ovarian cancer

BMJ ◽  
2020 ◽  
pp. m3773
Author(s):  
Lindsay Kuroki ◽  
Saketh R Guntupalli

ABSTRACTOvarian cancer is the third most common gynecologic malignancy worldwide but accounts for the highest mortality rate among these cancers. A stepwise approach to assessment, diagnosis, and treatment is vital to appropriate management of this disease process. An integrated approach with gynecologic oncologists as well as medical oncologists, pathologists, and radiologists is of paramount importance to improving outcomes. Surgical cytoreduction to R0 is the mainstay of treatment, followed by adjuvant chemotherapy. Genetic testing for gene mutations that affect treatment is the standard of care for all women with epithelial ovarian cancer. Nearly all women will have a recurrence, and the treatment of recurrent ovarian cancer continues to be nuanced and requires extensive review of up to date modalities that balance efficacy with the patient’s quality of life. Maintenance therapy with poly ADP-ribose polymerase inhibitors, bevacizumab, and/or drugs targeting homologous recombination deficiency is becoming more widely used in the treatment of ovarian cancer, and the advancement of immunotherapy is further revolutionizing treatment targets.

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Shoukat Ali

Epithelial ovarian cancer is most common gynecologic malignancy in Pakistan. Primary cytoreductive surgery followed by adjuvant chemotherapy is current standard of care for most of the patients with epithelial ovarian cancer, however neoadjuvant chemotherapy followed by surgery is acceptable alternate option for patients presenting with inoperable advanced disease initially. For most of the stage IV ovarian cancer patients, systemic chemotherapy is mainstay of treatment, but other approaches have been emerged for advanced disease including targeted agents, hormonal therapy and PARP inhibitors.


1970 ◽  
Vol 10 (2) ◽  
pp. 128-131
Author(s):  
Azam Sadat Mousavi ◽  
Fariba Behnamfar ◽  
Nili Mehrdad

Ovarian carcinoma is the second most common gynecologic cancer and the leading cause of death from gynecologic malignancy. The management of recurrent ovarian cancer has been individualized. Reports of recurrence in supradiaphragmatic lymph nodes are rare. We describe the finding of metastatic tumor involving cervical, submandibular and suboccipital lymph nodes in a 77-year-old patient with ovarian carcinoma. Keywords: scalene lymph node, ovarian cancer, lymphadenopathy, recurrence   doi: 10.3329/jom.v10i2.2830   J MEDICINE 2009; 10 : 128-131


2020 ◽  
Vol 30 (4) ◽  
pp. 509-514
Author(s):  
Irena Rohr ◽  
Sara Alavi ◽  
Rolf Richter ◽  
Maren Keller ◽  
Radoslav Chekerov ◽  
...  

BackgroundMaintenance therapy induces remission and prolongs disease free interval in primary and recurrent ovarian disease. For the treatment decision making process, aspects of quality of life and patients′ preferences are crucial, despite the fact that scientific data are lacking. Therefore, we conducted this European-wide study in patients with ovarian cancer.MethodsA 25 item questionnaire was provided to ovarian cancer patients via the internet or as a paper version in 10 European countries (Austria, Belgium, France, Germany, Italy, Romania, Slovenia, Finland, Turkey, and Spain). Data recorded were demographics, tumor stage, therapy after firstline and recurrent disease, preferences for administration, and expectations concerning maintenance therapy.ResultsOverall, 1954 patients participated from September 2013 to March 2016; 42% had recurrent disease. Most patients (98%) with primary epithelial ovarian cancer underwent surgery followed by chemotherapy (91%). Almost one-third of participants (29%) were receiving maintenance therapy whereas 45% had only heard of it. For 70% of patients with primary epithelial ovarian cancer, they heard about maintenance therapy from their doctor, 10% heard about maintenance therapy from other patients, and 8% from the internet. The main source of information about maintenance therapy in patients with epithelial ovarian cancer relapse was from the treating physician (72%), from other patients (8%), and from the internet (7%). For patients undergoing maintenance therapy, the four most disturbing adverse effects were polyneuropathy (37%), nausea (36%), hair loss (34%), and vomiting (34%). The main objective of maintenance treatment, as perceived by patients, was to increase the chances of cure (73%), improvement in quality of life (47%), and delay in tumor growth (37%). Many patients were willing to undergo maintenance therapy until tumor progression (38%) and 39% would prefer oral administration. No significant differences were detected in the cross country subanalysis regarding expectations of maintenance therapy and patients with primary or relapsed ovarian cancer.ConclusionPatients with ovarian cancer were willing to accept maintenance therapy of prolonged duration and preferred oral administration. There is still a gap between the efficacy of maintenance therapy and patient expectations. Patients need more information on the adverse effects and treatment goals of maintenance therapy to avoid misunderstandings.


Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3733
Author(s):  
Erin G. Hartnett ◽  
Julia Knight ◽  
Mackenzy Radolec ◽  
Ronald J. Buckanovich ◽  
Robert P. Edwards ◽  
...  

New treatment modalities are needed in order to improve the prognosis of women diagnosed with epithelial ovarian cancer (EOC), the most aggressive gynecologic cancer type. Most ovarian tumors are infiltrated by immune effector cells, providing the rationale for targeted approaches that boost the existing or trigger new anti-tumor immune mechanisms. The field of immuno-oncology has experienced remarkable progress in recent years, although the results seen with single agent immunotherapies in several categories of solid tumors have yet to extend to ovarian cancer. The challenge remains to determine what treatment combinations are most suitable for this disease and which patients are likely to benefit and to identify how immunotherapy should be incorporated into EOC standard of care. We review here some of the most promising immune therapies for EOC and focus on those currently tested in clinical trials.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18083-e18083 ◽  
Author(s):  
Sarah M. Belcher ◽  
Susan M. Sereika ◽  
Zan M. Dodson ◽  
Meghan K. Mattos ◽  
Teresa Hagan ◽  
...  

e18083 Background: Women with recurrent ovarian cancer (OC) experience a wide range of cancer- and treatment-related symptoms that negatively impact quality of life (QOL). Studies have reported healthcare disparities by geographic residence related to distance, time, and financial barriers to accessing high quality care. However, no studies have evaluated the impact of residence on symptoms and QOL in women with OC. Therefore, our objectives were to evaluate whether geographic residence (urban versus rural) is associated with symptoms and QOL in a sample of women with recurrent OC. Methods: The Center for Health Equity Research and Promotion conceptual framework guided analyses of baseline GOG-0259 data. We mapped zip codes to RUCA commuter codes and compared sociodemographic and clinical variables between rural and urban groups using two-sample t and chi-square tests. We used MANCOVA, adjusted for age and marital status, to test for associations between residence and symptoms (Symptom Representation Questionnaire) and QOL (Functional Assessment of Cancer Therapy-Ovarian). Results: Rural (n = 122, 25%) and urban (n = 374, 75%) women were similar in all sociodemographic and clinical comparisons except for marital status (83% vs. 70% married, p = .003). Women reported moderate symptom severity (M = 5.5, SD = 2.3) and QOL scores similar to other OC studies (M = 108.4, SD = 19.5). In multi-variate analyses, age and marital status were both associated with symptoms; marital status was associated with QOL. Geographical residence was not associated with either symptoms or QOL. Conclusions: Counter to previous research, there were no symptom or QOL disparities based on geographic residence in this sample. Possible explanations to be explored in future research include a) cooperative group selection bias for women with good access to care regardless of geographic residence and b) protective effects of marital status on symptoms and QOL.


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