First-line treatment of advanced ovarian cancer: current research and perspectives

Abstract

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.

Keywords::

• bevacizumab
• chemotherapy
• intraperitoneal
• ovarian cancer
• paclitaxel
• pegylated liposomal doxorubicin
• target therapy

Acknowledgements

The authors thank A Trocino for bibliography assistance.

Financial & competing interests disclosure

Sandro Pignata has received honoraria from Shering Plough, Roche and GlaxoSmithKline in the last 2 years. He is also supported by a grant from Associazione Italiana per la Ricerca sul Cancro (AIRC). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.