Trabectedin in Ovarian Cancer: is it now a Standard of Care?
Autor: | Immacolata Paciolla, C. Pisano, Sergio Venanzio Setola, Sandro Pignata, Nunzia Simona Losito, M. Di Napoli, Sabrina Chiara Cecere, Jole Ventriglia, Daniela Califano, Michele Orditura, Laura Arenare |
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Přispěvatelé: | Ventriglia, Jole, Paciolla, Ine, Cecere, Sabrina, Pisano, Carmen, DI NAPOLI, Marilena, Arenare, L, Setola, Sv, Losito, N, Califano, D, Orditura, Michele, Pignata, Sandro |
Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
0301 basic medicine
Oncology Drug Adult medicine.medical_specialty endocrine system diseases medicine.medical_treatment media_common.quotation_subject Gene mutation Carcinoma Ovarian Epithelial 03 medical and health sciences 0302 clinical medicine Immune system Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Radiology Nuclear Medicine and imaging Antineoplastic Agents Alkylating Trabectedin media_common Ovarian Neoplasms Chemotherapy business.industry Standard of Care Middle Aged medicine.disease 030104 developmental biology Mechanism of action 030220 oncology & carcinogenesis Toxicity Female medicine.symptom Neoplasm Recurrence Local Ovarian cancer business medicine.drug |
Popis: | In patients with recurrent ovarian cancer, the choice of second-line therapy is complex. Several factors have to be considered, such as platinum-free interval (PFI), residual toxicity from the previous treatments, BRCA1/2 gene mutation status. Trebectedin is a minor groove DNA binder derived from a marine organism that has shown efficacy in different settings in ovarian cancer therapy. It has been approved in the treatment of partially platinum sensitive (PPS) (PFI between 6 and 12 months) relapsed ovarian cancer according to the statistically significant progression-free survival (7.3 versus 5.8 months) and overall survival (22.2 versus 18.9 months) benefit compared with single-agent pegylated liposomal doxorubicin (PLD) in the OVA 301 phase III trial. This drug has been shown to prolong the time to first subsequent treatment and improve the efficacy of further platinum-based chemotherapy. The role of trabectedin/PLD followed by platinum combination compared with the reverse sequence in PPS is actually in evaluation in the INOVATYON phase III study, which will clarify the best sequence to be adopted in this setting. Trabectedin has been shown to be active in patient carriers of BRCA mutations, probably for its mechanism of action directly affecting DNA and it is actually tested as a single agent in some phase III trials in BRCA mutated and BRCAness ovarian cancer patients. Trabectedin is also active on the immune system. There is, therefore, the rational for new trials of a combination with immune checkpoint inhibitors. |
Databáze: | OpenAIRE |
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