First-line treatment of advanced ovarian cancer: current research and perspectives.
Epithelial ovarian cancer is the fourth biggest cause of cancer-related death in women. Over recent decades, improvements have been made in treatment outcome in terms of response rate and survival. To date, intensive surgical staging and cytoreduction, followed by primary chemotherapy with the carboplatin-paclitaxel regimen, are considered the gold standard for the management of this disease. Nevertheless, despite good initial response to systemic therapy after optimal debulking surgery, the long-term survival remains poor, with a high risk of recurrence. Furthermore, medical therapy of ovarian cancer impacts quality of life owing to the common occurrence of chemotherapy side effects, such as alopecia, neurotoxicity and fatigue. In order to improve the efficacy and reduce the toxicity of first-line chemotherapy, more than 10,000 women have been involved in worldwide randomized trials in the last 10 years. Several treatment alternatives have been investigated, such as intraperitoneal chemotherapy, alternative doublets and triplet regimens, in the effort to find an optimal first-line treatment strategy. In this review we discuss the results of these trials, the recent progresses and the most important ongoing studies, including those with emerging target and biological agents.
Marchetti
Claudia
C
Department of Urology and Gynecology, National Cancer Institute of Naples, via Mariano Semmola 80131, Naples, Italy.
Pisano
Carmela
C
Facchini
Gaetano
G
Bruni
Giovanni Salvatore
GS
Magazzino
Francesca Paola
FP
Losito
Simona
S
Pignata
Sandro
S
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local; D009375:Neoplasms, Glandular and Epithelial / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate; D016896:Treatment Outcome