Ovarian cancer - Criteria of response and the timing of regimen change in chemotherapy for ovarian cancer
Dept. of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan.Gan to kagaku ryoho. Cancer & chemotherapy 10/2012; 39(10):1471-6.
Recently, the resistant-to-paclitaxel/carboplatin therapy(TC), the standard first-line chemo-regimen for epithelial ovarian cancer(EOC), has been reported in subtypes of EOC, such as clear cell carcinoma and mucinous adenocarcinoma. The response to the chemo-regimen is evaluated by tumor markers and imaging of CT/MRI. The timing of regimen change depends on the identification of progressive disease(PD), using Rustin's criteria for CA125 and RECIST v1.1 for imaging, or severe adverse events(AEs>=grade 3, 4)in non-hematologic toxicities. For patients with refractory or recurrent EOC, the aim of their treatment was changed to keeping their quality of life for as long as possible with/without curing them from the disease. Thus, the selection of regimens for recurrent EOC should be suitable for the patient-friendly regimens, such as those with fewer AEs, out-patient- setting and shorter administration. As for molecular-targeted agents, bevacizumab and olaparib with TC therapy were reported to give patients significantly longer progression-free survival than control arms. Further investigation of immune-therapy or new agents for aiming total cell kill of tumor cell is should be warranted to obtain longer overall survival in patients with advanced EOC.
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