Management of recurrent ovarian cancer: when platinum-based regimens are not a therapeutic option

2019 ◽  
Vol 29 (9) ◽  
pp. 1431-1436 ◽  
Author(s):  
Alice Bergamini ◽  
Luca Bocciolone ◽  
Andrei Fodor ◽  
Massimo Candiani ◽  
Giorgia Mangili
Keyword(s):  
Ovarian Cancer ◽  
Personalized Medicine ◽  
Recurrent Disease ◽  
Therapeutic Option ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Recurrent Ovarian Cancer ◽  
Best Management ◽  
Free Interval ◽  
Treatment Alternatives

Ovarian cancer relapses have been traditionally classified according to the platinum-free interval, leading to an arbitrary categorization of possible scenarios and treatment options. Its relevance in assessing treatment strategies has been revised in the last several years, as the panorama is constantly changing in the era of personalized medicine and targeted therapies. Factors to be considered while defining the best management of recurrent disease, and, consequently, the available treatment alternatives are increasing. Platinum remains one of the milestones of ovarian cancer treatment, but for some patients it might not be an ideal choice for several reasons other than limited platinum sensitivity. This review aims to analyze the scenarios in which platinum is not considered suitable in the management of patients with recurrent ovarian cancer, and the currently available alternatives.

Novel treatment options in platinum-sensitive recurrent ovarian cancer: A review

2019 ◽  
Vol 152 (2) ◽  
pp. 416-425 ◽  
Author(s):  
Mary M. Mullen ◽  
Lindsay M. Kuroki ◽  
Premal H. Thaker
Keyword(s):  
Ovarian Cancer ◽  
Treatment Options ◽  
Recurrent Ovarian Cancer ◽  
Platinum Sensitive ◽  
Novel Treatment

scholarly journals Cost-Effectiveness Of Prophylaxis Treatment Strategies For Febrile Neutropenia In Recurrent Ovarian Cancer Patients

2013 ◽  
Vol 16 (3) ◽  
pp. A140 ◽  
Author(s):  
K. Fust ◽  
X. Li ◽  
M. Maschio ◽  
R. Barron ◽  
M.C. Weinstein ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cost Effectiveness ◽  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Treatment Strategies ◽  
Recurrent Ovarian Cancer

Trials With Impact on Clinical Management: First Line

2009 ◽  
Vol 19 (Suppl 2) ◽  
pp. S55-S62 ◽  
Author(s):  
Michael A. Bookman
Keyword(s):  
Ovarian Cancer ◽  
Cancer Biology ◽  
Treatment Options ◽  
Tumor Biology ◽  
Chemotherapy Resistance ◽  
Treatment Strategies ◽  
Weekly Dose ◽  
Primary Therapy ◽  
Phase 3 ◽  
Standard Regimen

Introduction:Advanced-stage epithelial ovarian cancer is generally managed with cytoreductive surgery and chemotherapy consisting of carboplatin and paclitaxel. Although initially responsive, most tumors recur and demonstrate progressive chemotherapy resistance. During the last 20 years, many thousands of women have participated in international front-line phase 3 trials that have contributed to our understanding of ovarian cancer biology and helped to define optimal treatment strategies. Emerging data from these trials need to be interpreted within an evolving paradigm of cancer biology, disease management, and availability of clinical resources.Methods:Survey of recent phase 3 trials and emerging principles of ovarian tumor biology.Results:There is no evidence that adding a third cytotoxic agent improves clinical outcomes. However, weekly dose-dense scheduling of paclitaxel appears superior to standard dosing.Conclusion:Primary therapy with carboplatin and paclitaxel remains a well-tolerated standard regimen, including the option of weekly paclitaxel dosing. Data are awaited from completed trials incorporating bevacizumab. Emerging biological paradigms will contribute to individualized treatment options in the future.

Impact of primary platinum-free interval and BRCA1/2 mutation status on treatment and survival in patients with recurrent ovarian cancer

2017 ◽  
Vol 146 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Michael A. Bookman ◽  
Jerzy E. Tyczynski ◽  
Janet L. Espirito ◽  
Thomas W. Wilson ◽  
Ancilla W. Fernandes
Keyword(s):  
Ovarian Cancer ◽  
Recurrent Ovarian Cancer ◽  
Mutation Status ◽  
Free Interval

Extending the Platinum-Free Interval with a Non-Platinum Therapy in Platinum-Sensitive Recurrent Ovarian Cancer

Oncology ◽  
2006 ◽  
Vol 71 (5-6) ◽  
pp. 320-326 ◽  
Author(s):  
Sandro Pignata ◽  
Gabriella Ferrandina ◽  
Giovanna Scarfone ◽  
Paolo Scollo ◽  
Franco Odicino ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Recurrent Ovarian Cancer ◽  
Platinum Sensitive ◽  
Free Interval

scholarly journals Prognostic factors modifying the treatment-free interval in recurrent ovarian cancer

2015 ◽  
Vol 139 (2) ◽  
pp. 228-235 ◽  
Author(s):  
Kevin H. Eng ◽  
Bret M. Hanlon ◽  
William H. Bradley ◽  
J. Brian Szender
Keyword(s):  
Ovarian Cancer ◽  
Prognostic Factors ◽  
Recurrent Ovarian Cancer ◽  
Free Interval

scholarly journals WHICH PATIENTS WITH OVARIAN CANCER SHOWS THE COMBINATION OF TRABECTEDIN WITH PEGYLATED LIPOSOMAL DOXORUBICIN

2013 ◽  
Vol 68 (11) ◽  
pp. 115-121 ◽  
Author(s):  
S. V. Khokhlova ◽  
M. V. Cherkasova ◽  
N. F. Orel ◽  
S. V. Limareva ◽  
I. Ya. Bazaeva ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Life Expectancy ◽  
Liposomal Doxorubicin ◽  
Pegylated Liposomal Doxorubicin ◽  
Recurrent Ovarian Cancer ◽  
High Rate ◽  
Comparable Efficacy ◽  
Recurrent Algorithm ◽  
Platinum Sensitive ◽  
Free Interval

Given the high rate of recurrence of ovarian cancer, the search for new therapeutic strategies are topical issue. According to various studies the effectiveness of drug treatment relapse depends on the platinum-free interval, increasing in proportion to its duration. If therapy is platinum-resistant recurrent ovarian cancer is a standard approach, the treatment of platinum-sensitive recurrent algorithm is not fully defined. Comparison of platinum and non-platinum combinations revealed the advantage of combined platinum- treatment for patients with platinum-free interval of more than 6 months without an increase in life expectancy. Non-platinum combination of trabectedin with pegylated liposomal doxorubicin has shown comparable efficacy with an advantage in overall survival in patients with platinum-free interval of 6–12 months. A platinum-free interval prolongation by the use of non-platinum mode increases the efficiency of subsequent platinum-based therapy, increasing the life expectancy of patients . Currently under study molecular markers and prognostic factors allowing to define a group of patients who have the greatest benefit from the use trabectedin with pegylated liposomal doxorubicin as second-line chemotherapy. 

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