title: Latest research and treatment of advanced-stage epithelial ovarian cancer.
abstract: The natural history of ovarian cancer continues to be characterized by late-stage presentation, metastatic bulky disease burden and stagnant mortality statistics, despite prolific drug development. Robust clinical investigation, particularly with modifications to primary treatment surgical goals and adjuvant therapy are increasing median progression-free survival and overall survival, although the cure rates have been affected only modestly. Maintenance therapy holds promise, but studies have yet to identify an agent and/or strategy that can affect survival. Recurrent disease is largely an incurable state; however, current intervention with selected surgery, combination and targeted therapy and investigational protocols are impacting progression-free survival. Ovarian cancer is a diverse and genomically complex disease, which commands global attention. Rational investigation must balance the high rate of discovery with lagging clinical investigation and limited patient resources. Nevertheless, growth in our armamentarium offers unprecedented opportunities for patients suffering with this disease. This Review presents and reviews the contemporary management of the disease spectrum termed epithelial 'ovarian' cancer and describes the direction and early results of clinical investigation.
authors: Department of Gynecologic Oncology & Reproductive Medicine, University of Texas, MD Anderson Cancer Center, 1155 Herman Pressler Drive, Houston, TX 77030, USA. rcoleman@ mdanderson.org
authors: Robert L
authors: RL
authors: Coleman
authors: Bradley J
authors: BJ
authors: Monk
authors: Anil K
authors: AK
authors: Sood
authors: Thomas J
authors: TJ
authors: Herzog
mesh_terms: D035843:Biomedical Research; D000077216:Carcinoma, Ovarian Epithelial; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D009375:Neoplasms, Glandular and Epithelial / Q000556:secondary / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000556:secondary / Q000628:therapy*
references: Eur J Gynaecol Oncol. 2012;33(3):321-3
references: 22873111
references: J Clin Oncol. 2003 Jul 1;21(13):2460-5
references: 12829663
references: Oncology. 2007;72(5-6):293-301
references: 18198490
references: N Engl J Med. 1996 Jan 4;334(1):1-6
references: 7494563
references: Gynecol Oncol. 2005 Oct;99(1):71-9
references: 16039699
references: J Obstet Gynaecol Res. 2006 Feb;32(1):99-106
references: 16445534
references: Int J Gynecol Cancer. 2011 Feb;21(2):289-95
references: 21270612
references: Oncology (Williston Park). 2011 Feb;25(2):156-65, 170
references: 21456387
references: Am J Obstet Gynecol. 1994 Apr;170(4):974-9; discussion 979-80
references: 8166218
references: Nat Rev Cancer. 2011 Jan;11(1):59-67
references: 21160526
references: Am J Nephrol. 2002 Jul-Aug;22(4):320-4
references: 12169862
references: J Clin Oncol. 2014 May 1;32(13):1302-8
references: 24637997
references: J Clin Oncol. 2010 Jul 1;28(19):3107-14
references: 20516432
references: J Clin Oncol. 2002 Mar 1;20(5):1248-59
references: 11870167
references: J Clin Oncol. 2000 Mar;18(6):1193-202
references: 10715288
references: AMIA Jt Summits Transl Sci Proc. 2012;2012:72-8
references: 22779056
references: Drugs. 2011 Jul 30;71(11):1397-412
references: 21812505
references: J Natl Cancer Inst. 2003 Sep 3;95(17):1320-9
references: 12953086
references: J Clin Oncol. 2012 Nov 10;30(32):4026-34
references: 23008289
references: N Engl J Med. 2010 Sep 2;363(10):943-53
references: 20818904
references: Cancer Res. 2008 Oct 1;68(19):8127-36
references: 18829572
references: J Cancer Res Clin Oncol. 1992;119(1):55-7
references: 1400568
references: J Clin Oncol. 1997 Jun;15(6):2183-93
references: 9196130
references: Cancer. 2000 Jan 1;88(1):144-53
references: 10618617
references: Nature. 2011 Jun 29;474(7353):609-15
references: 21720365
references: Best Pract Res Clin Obstet Gynaecol. 2002 Aug;16(4):585-96
references: 12413936
references: Gynecol Oncol. 2003 Feb;88(2):130-5
references: 12586591
references: Nature. 2005 Apr 14;434(7035):917-21
references: 15829967
references: N Engl J Med. 2009 Jul 9;361(2):123-34
references: 19553641
references: J Clin Oncol. 2010 Jul 10;28(20):3323-9
references: 20498395
references: Int J Gynecol Cancer. 2005 Sep-Oct;15(5):770-5
references: 16174222
references: J Clin Oncol. 2009 Jun 1;27(16):2686-91
references: 19332726
references: Nature. 2012 Oct 4;490(7418):61-70
references: 23000897
references: Cochrane Database Syst Rev. 2011 Jun 15;(6):CD006119
references: 21678351
references: J Clin Oncol. 1998 Feb;16(2):405-10
references: 9469322
references: Gynecol Oncol. 2012 Jan;124(1):10-4
references: 21917306
references: Gynecol Oncol. 2004 Apr;93(1):215-22
references: 15047239
references: J Clin Oncol. 2014 Feb 1;32(4):320-6
references: 24366937
references: Gynecol Oncol. 2004 Oct;95(1):1-8
references: 15385103
references: JAMA. 1983 Dec 9;250(22):3072-6
references: 6358558
references: Curr Oncol Rep. 2010 Nov;12(6):349-51
references: 20711821
references: Akush Ginekol (Sofiia). 2004;43(6):17-9
references: 15669647
references: Mol Cancer Ther. 2005 Apr;4(4):603-11
references: 15827334
references: Cancer Res. 2009 May 1;69(9):4036-42
references: 19383911
references: Gynecol Oncol. 2006 Aug;102(2):218-25
references: 16460787
references: Lancet. 2009 Oct 17;374(9698):1331-8
references: 19767092
references: Gynecol Oncol. 2008 Feb;108(2):276-81
references: 18063020
references: Lancet. 2003 Jun 21;361(9375):2099-106
references: 12826431
references: Gynecol Oncol. 1991 Aug;42(2):137-41
references: 1894172
references: Ann Surg Oncol. 2006 Dec;13(12):1702-10
references: 17009163
references: J Clin Oncol. 2011 Nov 1;29(31):4076-8
references: 21931032
references: J Natl Cancer Inst. 2000 May 3;92(9):699-708
references: 10793106
references: Nat Rev Cancer. 2010 Nov;10(11):803-8
references: 20944665
references: N Engl J Med. 2012 Apr 12;366(15):1382-92
references: 22452356
references: Int J Gynecol Cancer. 2009 Dec;19 Suppl 2:S63-7
references: 19955917
references: Cancer Gene Ther. 2011 Feb;18(2):100-9
references: 20865022
references: N Engl J Med. 2011 Dec 29;365(26):2473-83
references: 22204724
references: JAMA. 2011 Oct 12;306(14):1557-65
references: 21990299
references: N Engl J Med. 2011 Dec 29;365(26):2484-96
references: 22204725
references: Curr Oncol Rep. 2001 Jan;3(1):11-8
references: 11123864
references: Am J Pathol. 2009 May;174(5):1597-601
references: 19349352
references: Ecancermedicalscience. 2012;6:248
references: 22518199
references: Nat Rev Cancer. 2011 Sep 23;11(10):719-25
references: 21941283
references: Int J Gynecol Cancer. 2012 Feb;22(2):182-5
references: 22274314
references: J Clin Oncol. 2007 Nov 20;25(33):5165-71
references: 18024863
references: Ann Surg Oncol. 2012 Feb;19(2):597-604
references: 21732142
references: Gynecol Oncol. 2011 May 1;121(2):249-52
references: 21300398
references: Natl Cancer Inst Monogr. 1975 Oct;42:101-4
references: 1234624
references: Nat Rev Clin Oncol. 2011 Oct 11;8(12):735-41
references: 21989071
references: Cancer. 2009 Mar 15;115(6):1234-44
references: 19189349
references: Gynecol Oncol. 2006 Jun;101(3):436-40
references: 16325893
references: Int J Surg Oncol. 2012;2012:613980
references: 22919475
references: J Clin Oncol. 2007 Jul 1;25(19):2811-8
references: 17602086
references: Curr Pharm Des. 2012;18(25):3754-69
references: 22591421
references: Clin Cancer Res. 2012 Oct 15;18(20):5806-15
references: 22912389
references: Gynecol Oncol. 2006 Dec;103(3):1070-6
references: 16875720
references: BMC Cancer. 2006 Jun 08;6:153
references: 16759398
references: J Clin Oncol. 2007 Jul 10;25(20):2873-83
references: 17617518
references: Semin Oncol. 2000 Jun;27(3 Suppl 7):31-6
references: 10952124
references: Nat Clin Pract Oncol. 2006 Nov;3(11):604-11
references: 17080178
references: Cochrane Database Syst Rev. 2010 Sep 08;(9):CD007414
references: 20824860
references: Br J Cancer. 2011 Sep 27;105(7):890-6
references: 21878937
references: Lancet. 2010 Oct 2;376(9747):1155-63
references: 20888993
references: Obstet Gynecol. 2002 Jun;99(6):1008-13
references: 12052591
references: BMC Public Health. 2011 Oct 18;11:811
references: 22008649
references: J Clin Oncol. 2012 Feb 1;30(4):372-9
references: 22203755
references: J Clin Oncol. 2003 Sep 1;21(17):3194-200
references: 12860964
references: Gynecol Oncol. 2011 Jul;122(1):111-5
references: 21497382
references: Int J Gynecol Pathol. 2003 Jan;22(1):37-41
references: 12496696
references: Ann Surg Oncol. 2007 Mar;14(3):1136-42
references: 17195909
references: Cancer Res. 2012 Jun 1;72(11):2701-4
references: 22593197
references: J Clin Oncol. 1991 Mar;9(3):389-93
references: 1999708
references: J Clin Oncol. 2012 Jun 10;30(17):2039-45
references: 22529265
references: Cancer Treat Rev. 2012 Jun;38(4):272-83
references: 21764518
references: Gynecol Oncol. 2009 Jul;114(1):48-52
references: 19361839
references: J Clin Oncol. 2006 Oct 1;24(28):4528-30
references: 17008689
references: J Clin Oncol. 2012 Feb 1;30(4):345-7
references: 22184398
references: Int J Gynecol Cancer. 2006 Jan-Feb;16 Suppl 1:47-53
references: 16515567
references: Gynecol Oncol. 2006 Nov;103(2):446-50
references: 16643994
references: J Pathol. 2007 Jan;211(1):26-35
references: 17117391
references: Clin Cancer Res. 2011 Dec 1;17(23):7359-72
references: 21903772
references: J Clin Oncol. 1989 Nov;7(11):1748-56
references: 2681557
references: Clin Cancer Res. 2008 Aug 15;14(16):5198-208
references: 18698038
references: Clin Adv Hematol Oncol. 2006 Jan;4(1):36-7
references: 16562368
references: Cancer. 2006 May 1;106(9):1933-9
references: 16572412
references: J Clin Oncol. 2006 Oct 10;24(29):4699-707
references: 16966687
references: J Clin Oncol. 2008 Feb 20;26(6):890-6
references: 18281662
references: Cochrane Database Syst Rev. 2012 Aug 15;(8):CD005343
references: 22895947
references: Acta Oncol. 2002;41(5):418-24
references: 12442916
references: N Engl J Med. 2006 Jan 5;354(1):34-43
references: 16394300