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Palliative systemic therapy for women with recurrent epithelial ovarian cancer: current options.

ABSTRACT: OBJECTIVES:To review the available systemic treatments for women with recurrent ovarian cancer. METHODS:A literature review was conducted for recurrent ovarian cancer articles in English, including randomized trials, Phase II trials, or reviews. RESULTS:We discuss the efficacy and toxicity outcomes associated with systemic therapy for platinum-sensitive and platinum-resistant ovarian cancer. Clearly, platinum-based combination systemic therapy shows a prolonged progression-free interval compared with single-agent chemotherapy with a low toxicity profile. No clear superior management strategy exists for platinum-resistant/refractory disease. Novel targeted antiangiogenic agents (eg, bevacizumab), angiopoeitin inhibitors (eg, AMG 386), and poly ADP ribose polymerase inhibitors (eg, olaparib) are reviewed. CONCLUSION:Although combination platinum-based chemotherapy has shown benefits for women with platinum-sensitive recurrent ovarian cancer, the optimal treatment strategy for those with platinum-resistant or platinum-refractory disease is not clear. Molecular and genetic targeted therapies may provide opportunities for those women with tumor profiles that show sensitivity for specific agents.

SUBMITTER: Elit L

PROVIDER: S-EPMC3585576 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Palliative systemic therapy for women with recurrent epithelial ovarian cancer: current options.

Elit Laurie L Hirte Hal H

OncoTargets and therapy 20130226

<h4>Objectives</h4>To review the available systemic treatments for women with recurrent ovarian cancer.<h4>Methods</h4>A literature review was conducted for recurrent ovarian cancer articles in English, including randomized trials, Phase II trials, or reviews.<h4>Results</h4>We discuss the efficacy and toxicity outcomes associated with systemic therapy for platinum-sensitive and platinum-resistant ovarian cancer. Clearly, platinum-based combination systemic therapy shows a prolonged progression- ...[more]

PMID: 23459506

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Project description:PurposeMetastatic, persistent, or recurrent epithelial ovarian cancer (MPR-EOC) remains a significant threat to patient mortality despite advances in novel targeted agents. Radiation therapy (RT) is often used as a palliative option. We report outcomes of a large series of MPR-EOC patients treated with modern palliative RT (PRT) in an era of novel systemic therapies.Methods and materialsA retrospective review was conducted of women treated with PRT for MPR-EOC between 2007 and 2019 at an academic institution. Clinical response rates were recorded at <1 month, 1 to 3 months, and >3 months. Radiographic responses were categorized by RECIST 1.1 criteria. Overall response rate (ORR) was the sum of complete and partial response. Linear regression analyses of baseline characteristics were conducted for statistical testing.ResultsEighty-six patients with PMR-OC received 120 courses of palliative RT. Median follow-up was 8.6 months. Median age was 61 (range, 22-82). Thirty-six percent of women received central nervous system (CNS)-directed RT. In addition, 43% received targeted therapies before RT. Clinical ORR within 1 month and at last follow-up for non-CNS lesions was 79% and 61% (69% and 88% for CNS lesions, respectively). High-grade serous lesions were more likely to have clinical response (P = .04). Biologically effective doses (BED) >39 Gy were associated with improved clinical response in CNS lesions (P = .049). Bony sites were associated with worse clinical (P = .004) response in non-CNS lesions compared with soft tissue or nodal sites. Acute or late grade 3+ toxicities with bevacizumab were low (8.7%/4.3%).ConclusionsPRT offers excellent rates of response for symptomatic patients with MPR-EOC within 1 month of treatment, with durable responses beyond 3 months. High-grade serous lesions were associated with improved response in all patients. Higher BED and soft tissue or nodal sites were associated with improved response in CNS and non-CNS patients, respectively. Acute or late toxicities with bevacizumab and PRT were low. Prospective investigation is warranted to determine the optimal PRT regimen.

Dataset Information

Palliative systemic therapy for women with recurrent epithelial ovarian cancer: current options.

Publications

Palliative systemic therapy for women with recurrent epithelial ovarian cancer: current options.

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