A new therapeutical approach: Topotecan plus gemcitabine in the treatment of patients with relapsed ovarian cancer after failure of first‐line chemotherapy with paclitaxel and platinum

Purpose of ReviewOvarian cancer (OvCa) is the most lethal of all gynecological cancers, with a 5-year survival around 46%, mainly due to limitations in early diagnosis and treatment. Consequently, the chemoprevention of OvCa emerges as an important option to control this dismal disease. Here, we discuss the role of risk assessment in the design of chemoprevention strategies for OvCa, describe candidate agents, and assess future directions in this field.Recent FindingsOvCa chemoprevention represents an opportunity for all women, especially those at high risk such as carriers of BRCA1 or BRCA2 mutations. The use of oral contraceptives confers substantial protection against OvCa including women at high risk, which increases with longer use. Despite strong evidence for their efficacy, safety concerns and the magnitude of the requisite interventional clinical trials seem to have precluded definitive studies of oral contraceptives for this application. Several other classes of drugs, including non-steroidal anti-inflammatory drugs, retinoids, angiopreventive agents, poly(ADP-ribose) polymerase inhibitors, and tyrosine kinase inhibitors have shown promise for OvCa chemoprevention.SummaryCurrently, no agent is proven by interventional trials to possess chemopreventive properties against OvCa. The key opportunities in the chemoprevention of OvCa include the development of surrogate biomarkers for OvCa, the molecular definition of OvCa risk that will help select those who may benefit the most from chemoprevention, the identification of additional agents likely driven by understanding the molecular pathogenesis of OvCa, and the development of dedicated resources and support mechanisms for OvCa. Overall, there is significant optimism for the future of OvCa chemoprevention.

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The Chemoprevention of Ovarian Cancer: the Need and the Options

Kathawala

Kudelka

Rigas

2018

Curr Pharmacol Rep

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Recent developments in the clinical activity of topoisomerase-1 inhibitors

Haglof

Popa

Hochster

2006

Update on Cancer Therapeutics

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A phase I trial of gemcitabine and topotecan in previously treated ovarian or peritoneal cancer: A Gynecologic Oncology Group study

Chen

Fleming

Mitchell

et al. 2006

Gynecologic Oncology

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A new therapeutical approach: Topotecan plus gemcitabine in the treatment of patients with relapsed ovarian cancer after failure of first‐line chemotherapy with paclitaxel and platinum

Abstract: The results demonstrate feasibility and the tolerability of topotecan in combination with gemcitabine in recurrent ovarian cancer patients. Based on these results a phase-II study was conducted to evaluate the efficacy of this new combination.

Cited by 9 publications

References 32 publications

The Chemoprevention of Ovarian Cancer: the Need and the Options

The Chemoprevention of Ovarian Cancer: the Need and the Options

Recent developments in the clinical activity of topoisomerase-1 inhibitors

A phase I trial of gemcitabine and topotecan in previously treated ovarian or peritoneal cancer: A Gynecologic Oncology Group study

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