Abstract
Molecularly targeted therapy is relatively new to ovarian cancer despite the unquestionable success with these agents in other solid tumours such as breast and colorectal cancer. Advanced ovarian cancer is chemosensitive and patients can survive several years on treatment. However chemotherapy diminishes in efficacy over time whilst toxicities persist. Newer biological agents that target explicit molecular pathways and lack specific chemotherapy toxicities such as myelosuppression offer the advantage of long-term therapy with a manageable toxicity profile enabling patients to enjoy a good quality of life. In this review we appraise the emerging data on novel targeted therapies in ovarian cancer. We discuss the role of these compounds in the front-line treatment of ovarian cancer and in relapsed disease; and describe how the development of predictive clinical, molecular and imaging biomarkers will define the role of biological agents in the treatment of ovarian cancer.
Highlights
Ovarian cancer is a leading cause of cancer mortality being the most frequent cause of death from gynaecological cancer, and the fourth most frequent cause of death from cancer in women in Europe and the USA
This study evaluates if maintenance bevacizumab for 16 cycles beyond the 6 cycles of standard carboplatin and paclitaxel improves survival when compared with 6 cycles of carboplatin and paclitaxel
Novel agents are often combined with existing cytotoxics, such as in the ICON-7 trial in which patients with newly diagnosed ovarian epithelial, fallopian tube or primary peritoneal cancer receive carboplatin and paclitaxel chemotherapy with or without bevacizumab
Summary
Ovarian cancer is a leading cause of cancer mortality being the most frequent cause of death from gynaecological cancer, and the fourth most frequent cause of death from cancer in women in Europe and the USA. The relapse rate in early stage ovarian cancer ranges between 10%–40% whilst more than 50% of patients with advanced disease will eventually progress. In platinum-sensitive disease i.e. where the treatment-free interval (TFI) is more than 6 months the response rates can be greater than 50%, but it is only 10–20% for platinumresistant disease (TFI
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