Abstract
The incidence of ovarian cancer, which has had a poor prognosis, is increasing annually. Currently, the prognosis is expected to improve with the use of molecular-targeted drugs and immune checkpoint inhibitors as maintenance therapies after the first-line chemotherapy. The GOG218 and ICON7 studies reported the usefulness of bevacizumab and the SOLO-1 and PRIMA (A Phase 3, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study of Niraparib Maintenance Treatment in Patients With Advanced Ovarian Cancer Following Response on Front-Line Platinum-Based Chemotherapy) studies have reported the usefulness of olaparib and niraparib, respectively. The ATHENA study investigating the usefulness of rucaparib is currently ongoing. Although clinical studies of immune checkpoint inhibitors are lagging in the field of gynecology, many clinical studies using programmed death cell-1 (PD-1) and PD-1 ligand 1 (PD-L1) antibodies are currently ongoing. Some biomarkers have been identified for molecular-targeted drugs, but none have been identified for immune checkpoint inhibitors, which is a challenge that should be addressed in the future.
Highlights
This dd-paclitaxel + carboplatin (TC) therapy was investigated by the Japanese Gynecologic Oncology Group (JGOG) in the JGOG3016 phase 3 study that compared the usefulness of dose-dense TC (dd-TC) and TC therapies in 631 patients with stage II–IV epithelial ovarian, fallopian tube, or peritoneal cancer [10]
This was a phase 2 study of 1021 patients with stage IIB–IV epithelial ovarian, fallopian tube, or primary peritoneal cancer; grade 3 clear cell carcinoma, or stage I–IIA carcinosarcoma, where TC therapy was administered as the first-line chemotherapy for 4 to 8 cycles and bevacizumab was administered as maintenance therapy for up to 36 cycles to verify its safety and efficacy
Attention is focused on maintenance therapy, which was previously considered ineffective
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Overall survival (OS) did not improve in any of the GOG178 [5], AGO-GINECO [6], MITO-1 [7], or After-6 [8] studies, which examined the usefulness of maintenance therapy after the first-line chemotherapy in improving the prognosis of ovarian cancer. The prognosis is expected to improve with the use of molecular-targeted drugs and immune checkpoint inhibitors as maintenance therapy instead of cytotoxic anticancer drugs. Maintenance therapy with molecular-targeted agents following the first-line chemotherapy has drawn attention. Immune checkpoint inhibitors are drawing attention as new drugs that show high efficacy in the treatment of solid cancers. We will provide an introductory review of the characteristics of maintenance therapy with molecular-targeted drugs and immune checkpoint inhibitors after the first-line chemotherapy for ovarian cancer, based on the results of clinical studies.
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