Optimal primary therapy of ovarian cancer
| Autor: | M.A. Bookman |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Oncology medicine.medical_specialty Paclitaxel Bevacizumab medicine.medical_treatment Carcinoma Ovarian Epithelial Carboplatin 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Adjuvant therapy Humans Neoplasms Glandular and Epithelial Neoadjuvant therapy Ovarian Neoplasms business.industry Cancer Hematology medicine.disease Debulking Quality Improvement Chemotherapy regimen Neoadjuvant Therapy 030104 developmental biology chemistry Chemotherapy Adjuvant 030220 oncology & carcinogenesis Female Cisplatin business Ovarian cancer medicine.drug |
| Zdroj: | Annals of Oncology. 27:i58-i62 |
| ISSN: | 0923-7534 |
| DOI: | 10.1093/annonc/mdw088 |
| Popis: | Background Epithelial ovarian cancer continues to have the highest case–fatality ratio of all gynecologic cancers, in spite of ongoing advances in risk-assessment, genomics, tumor biology, cytoreductive surgery, chemotherapy, and molecular-targeted interventions. Primary treatment options for advanced-stage disease not only should reflect current best standards, but also need to be tailored for individual patients, with consideration of local resources. Methods Formulation of recommendations for optimal primary therapy based on a selective review of data from completed randomized trials, analysis of ongoing trials, and integration with current tumor biology, within the context of individualized clinical care. Recommendations were presented for discussion during an international meeting of experts in ovarian cancer treatment. Results Key recommendations include full adjuvant therapy for early-stage high-grade serous cancer; tailored utilization of neoadjuvant chemotherapy based on patient comorbidities, extent of disease, and likelihood of achieving optimal surgical cytoreduction; preferred utilization of carboplatin with weekly paclitaxel as primary therapy; consideration of intraperitoneal cisplatin-based therapy in appropriate patients; avoidance of maintenance chemotherapy; lack of necessity for bevacizumab during primary chemotherapy and primary maintenance; acknowledgement of research opportunities and priorities. Conclusions Integrated multidisciplinary care, including cytoreductive surgery and platinum-based chemotherapy, remain central to the optimal management of women with advanced-stage ovarian cancer. However, even with recent technical advances, the impact on disease-related mortality is limited, and more attention will be focused on the early integration of research, particularly with neoadjuvant chemotherapy and interval cytoreductive surgery. |
| Databáze: | OpenAIRE |
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