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Novel treatment options in platinum-sensitive recurrent ovarian cancer: A review

  • Mary M. Mullen
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, Alvin J. Siteman Cancer Center, St Louis, MO, United States of America
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  • Lindsay M. Kuroki
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, Alvin J. Siteman Cancer Center, St Louis, MO, United States of America
    Search for articles by this author
  • Premal H. Thaker
    Correspondence
    Corresponding author at: Department of Obstetrics & Gynecology, 660 South Euclid Avenue, Mail Stop 8064-97-905, United States of America.
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, Alvin J. Siteman Cancer Center, St Louis, MO, United States of America
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Published:November 05, 2018DOI:https://doi.org/10.1016/j.ygyno.2018.10.023

      Highlights

      • The standard of care for the treatment of platinum-sensitive recurrent ovarian cancer is platinum-combination chemotherapy.
      • Platinum therapy should not be delayed in order to prolong the progression free interval.
      • This review discusses various angiogenesis inhibitors including bevacizumab, cediranib, and trebananib.
      • This review assesses the benefits, side effects, and future development of PARPi in platinum-sensitive recurrent patients.
      • More research is necessary to optimize molecularly targeted therapy leading to improved survival for ovarian cancer patients.

      Abstract

      Epithelial ovarian cancer (EOC) is the leading cause of death due to gynecologic malignancy. The majority of advanced stage EOC patients, even those who respond well to frontline therapy, will ultimately recur and succumb to their disease. In platinum-sensitive EOC patients, or those who recur ≥6 months from initial diagnosis, treatment of recurrent disease has traditionally consisted of repeat platinum-based chemotherapy. Secondary cytoreduction remains controversial. Due to recent advances in molecularly targeted treatment options, outcomes for advanced stage EOC patients are significantly improving and hold great promise. This review discusses pivotal trials establishing platinum-based combination chemotherapy as the standard of care and addresses the utility of increasing a patient's platinum-free interval. It then discusses the role of anti-angiogenesis therapeutics, specifically bevacizumab, cediranib, and trebananib and their side effects. Lastly, it reviews key trials for the three poly-adenosine diphosphate [ADP]-ribose polymerases (PARP) inhibitors that have been FDA-approved for maintenance therapy in platinum-sensitive recurrent EOC: olaparib, rucaparib, and niraparib. This review concludes with a discussion regarding ongoing and future clinical trials.

      Keywords

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