[Place of autologous and allogeneic hematopoietic stem cell transplantation in ovarian cancer].
For several years, research for treatment of advanced ovarian cancer in first line or in relapse was made on the basis of two concepts. The first one is to improve the response rate by increasing the dose of chemotherapy delivered by high dose chemotherapy consolidation. The second concept is the development of an immunological antitumoral effect following allogeneic hematopoietic stem cells transplantation (HSC). The autologous HSC transplantation is required to first concept because of medullar toxicities induced by high dose chemotherapy. This therapeutic was widely studied in first line of advanced ovarian cancer. The recent phases III demonstrate an increase of the toxicity without efficacy improvement compared with the standard doses of chemotherapy. In relapse, the response rate is improved but an important toxicity is observed with low response duration. Evaluation of high dose of topotecan in association with the carboplatine is currently on going. Allogeneic HSC transplantation presents a potential interest because of immunogeneic control against tumour. However, the direct proof of immunotherapy efficacy on OC in a clinical study is still missing, toxicities should not be disregarded.
Nayl
B
B
Centre Jean-Perrin, Département de médecin oncologique, 58 Rue Montalembert, 63011 Clermont-Ferrand, France.
Cabrespine-Faugeras
A
A
Maliki
Ym
Y
Bay
J-O
JO
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D012074:Remission Induction / Q000379:methods; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous