Maintenance therapy for newly and recurrent epithelial ovarian cancer: current therapies and future perspectives

医学 贝伐单抗 奥拉帕尼 维持疗法 耐受性 背景(考古学) 卵巢癌 肿瘤科 内科学 重症监护医学 癌症 化疗 不利影响 聚ADP核糖聚合酶 古生物学 生物化学 化学 生物 聚合酶 基因
作者
Vanda Salutari,Elena Giudice,Domenica Lorusso
出处
期刊:Current Opinion in Obstetrics & Gynecology [Ovid Technologies (Wolters Kluwer)]
卷期号:36 (1): 9-17 被引量:2
标识
DOI:10.1097/gco.0000000000000931
摘要

Purpose of review Epithelial ovarian cancer (EOC) is the fifth cause of cancer death among women, and 70–80% of patients relapse within 2 years from the last cycle of first-line chemotherapy despite a complete response to chemotherapy and optimal debulking surgery. In this context, the goal of the maintenance treatment strategy is to prolong the time to recurrence. The recent development of targeted molecular therapies resulted in a broader spectrum of maintenance therapeutic options with consequent higher clinical benefit but less toxicity. This review summarizes the currently available maintenance strategies for newly and recurrent EOC, focusing on the decision-making process to personalize treatment and future perspectives. Recent findings Over the past 10 years, several studies have demonstrated the clear benefit in terms of survival with the addition of a maintenance treatment strategy over the ‘watchful waiting’ approach both in the first line and recurrent setting. Since December 2016, the United States Food and Drug Administration and European Medicines Agency have approved four drugs for ovarian cancer maintenance based on the results of several clinical trials demonstrating efficacy and tolerability. These include the antiangiogenic drug Bevacizumab and three polyadenosine diphosphate-ribose polymerase (PARP) inhibitors: olaparib, niraparib, and rucaparib. Summary These data led American and European Treatment guidelines to include bevacizumab, olaparib, niraparib, rucaparib, and combination bevacizumab-olaparib as maintenance treatment options in first-line and recurrent ovarian cancer therapy. However, with the availability of different maintenance options, identifying the best treatment choice for each patient can be challenging, and several clinical and molecular aspects have to be taken into account in the decision-making process.
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