Controversy in treatment of advanced ovarian cancer

Abstract

Advanced epithelial ovarian cancer has a median progression-free survival of 16–21 months and median overall survival of 32–57 months. Standard treatment is cytoreductive surgery—either upfront or after neoadjuvant chemotherapy—followed by six cycles of 3-weekly paclitaxel and carboplatin. Attempts to improve survival by addition of a third cytotoxic drug have been unsuccessful, although encouraging results have been reported for treatment with intravenous paclitaxel plus intraperitoneal cisplatin and paclitaxel, and bevacizumab plus paclitaxel and carboplatin followed by maintenance with bevacizumab. 1 Burger RA Brady MF Bookman MA et al. Gynecologic Oncology GroupIncorporation of bevacizumab in the primary treatment of ovarian cancer. N Engl J Med. 2011; 365: 2473-2483 Crossref PubMed Scopus (1640) Google Scholar , 2 Perren TJ Swart AM Pfisterer J et al. ICON7 InvestigatorsA phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med. 2011; 365: 2484-2496 Crossref PubMed Scopus (1516) Google Scholar Long-term results of dose-dense paclitaxel and carboplatin versus conventional paclitaxel and carboplatin for treatment of advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer (JGOG 3016): a randomised, controlled, open-label trialDose-dense treatment offers better survival than conventional treatment and is a potential new standard of care for first-line chemotherapy for patients with advanced epithelial ovarian cancer. Full-Text PDF