Maintenance chemotherapy for ovarian cancer

Mei, Ling; Fang, Fang; Dong, Wei; Chen, Hui; Liu, Guan Jian; Xie, Huan; Wang, Xun

doi:10.1002/14651858.cd007414

Cited by 33 publications

(42 citation statements)

References 12 publications

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“…The maintenance or consolidation therapy is not standard for ovarian carcinoma. [39] We revealed that DFS and OS of our patients who received more than six cycles of chemotherapy did not provide additional benefit. The shorter survival rate was observed in patients who were treated more than 6 cycles.…”

Section: Discussionmentioning

confidence: 63%

Assessment of prognostic factors in epithelial ovarian cancer

Onal

Köstek

Hacioðlu³

et al. 2017

EJMO

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O varian cancers constitute 4% of female cancers. Ovarian cancer is the second most common gynecological cancer.[1] About 95% of the ovarian malignancies are epithelial tumors. Serous ovarian cancer is the most common epithelial ovarian cancers. Its treatment modalities include surgery, adjuvant chemotherapy, and supportive therapy. It has a rather poor course of prognosis. 5-year survival rate of ovarian cancer is about 40-45%. This ratio ranges from 15% to 95% based on various factors affecting prognosis. [2][3][4][5][6][7] There are numerous clinical, pathological and biological prognostic factors. Clinical factors affecting prognosis include age, performance status, menarche age, menopausal status, and parity; pathologic factors include stage, pathologic grade, cytologic findings, the presence of ascites and residual disease after surgery and biological factors comprise various gene expressions. Furthermore, the cheObjectives: Ovarian cancer is the second most common gynecological cancer, and has a 5-year survival rate of about 40% to 45%. This ratio ranges from 15% to 95%, based on prognostic factors. There are numerous clinical, pathological and biological factors related to prognosis. The aim of this study was to assess prognostic factors in advanced epithelial ovarian cancer. Methods: A total of 119 stage III and stage IV ovarian cancer patients were evaluated. The patient's age, menopausal status, age of menarche, number of children, height and weight values, surgery, tumor histopathological features, presence of metastasis, residual tumor volume, presence of ascites, abdominal lavage cytology, chemotherapy regimen, number of chemotherapy cycles, the first and last chemotherapy dates, relapse, and recent status were evaluated. Results: The median age of the study patients was 54 years (minimum: 34, maximum: 79 years). The pathological stages were 10 (8.6%) patients with IIIA, 6 (5%) patients with IIIB, 76 (63.9%) patients with IIIC, and 27 (22.7%) patients with stage IV. In multivariate analysis, age of diagnosis (hazard ratio [HR]: 0.44; 95% confidence interval [CI], 0.22-087; p=0.01), postoperative tumor residual status (HR: 0.32; 95% CI, 0.14-0.71; p<0.01), number of adjuvant chemotherapies (HR: 0.48; 95% CI, p=0.04), and platinum sensitivity (HR: 0.37; 95% CI, 0.18-0.74; p<0.01) were found to be independent variables related to longer survival. Notably, a patient treated with more than 6 cycles of chemotherapy had a worse prognosis. Conclusion: Independent indicators of a poor prognosis in our study were determined to be advanced age at diagnosis, a residual tumor more than 2 cm in size, more than 6 cycles of chemotherapy, and the presence of platinumresistant disease. A multidisciplinary approach is needed to improve prognosis.

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Section: Discussionmentioning

confidence: 63%

Assessment of prognostic factors in epithelial ovarian cancer

Onal

Köstek

Hacioðlu³

et al. 2017

EJMO

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“…The use of maintenance therapy following platinum-based chemotherapy has been investigated and reviewed (165,166). Monthly paclitaxel treatment (for a duration of either 3 months or 12 months) has been assessed in patients with ovarian cancer following completion of NACT (167); no benefit in overall survival was observed with 12 month paclitaxel treatment, compared to treatment for 3 months, but PFS was longer in the 12-month versus 3-month groups.…”

Section: [H1]managementmentioning

confidence: 99%

Ovarian cancer

Matulonis

Sood

Fallowfield

et al. 2016

Nat Rev Dis Primers

938

787

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Ovarian cancer is not a single disease and can be subdivided into at least five different 2 histological subtypes that have different identifiable risk factors, cells of origin, molecular compositions, clinical features and treatments. Ovarian cancer is a global problem, is typically diagnosed at late stage, and has no effective screening strategy. Standard treatments for newly diagnosed cancer consist of cytoreductive surgery and platinum-based chemotherapy. In recurrent cancer, chemotherapy, anti-angiogenic agents, and poly (ADP ribose) polymerase (PARP) inhibitors are used and immunological therapies are currently being tested. High-grade serous carcinoma (HGSC) is the most commonly diagnosed form of ovarian cancer and is typically very responsive to platinum-based chemotherapy at diagnosis. However, in addition to the other histologies, HGSCs frequently relapse and become increasingly resistant to chemotherapy.Consequently, understanding the mechanisms underlying platinum resistance and finding ways to overcome them are active areas of study in ovarian cancer. Significant progress has been made in identifying genes associated with high risk of ovarian cancer (such as BRCA1 and BRCA2) as well as a precursor lesion of HGSC called a serous tubal intraepithelial carcinoma, which hold promise for identifying individuals at high risk of developing the disease and for developing prevention strategies. Competing interestsU.A.M. has served as a consultant for AstraZeneca, ImmunoGen, Pfizer, Genentech, and Merck.

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“…Current treatment of advanced cervical and epithelial ovarian cancer includes platinum-based multimodality therapy (1,2). Many patients with gynecologic cancer develop resistance to platinum drugs, thereby limiting further treatment options and decreasing overall survival rates (1,3).…”

Section: Introductionmentioning

confidence: 99%

“…Many patients with gynecologic cancer develop resistance to platinum drugs, thereby limiting further treatment options and decreasing overall survival rates (1,3). Gynecologic cancers are generally known as immunogenic, and prominent correlations exist between the infiltration of tumors by immune cells and clinical outcome (4,5).…”

Section: Introductionmentioning

confidence: 99%

Chemotherapy Alters Monocyte Differentiation to Favor Generation of Cancer-Supporting M2 Macrophages in the Tumor Microenvironment

et al. 2013

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Current therapy of gynecologic malignancies consists of platinum-containing chemotherapy. Resistance to therapy is associated with increased levels of interleukin (IL)-6 and prostaglandin E2 (PGE 2 ), 2 inflammatory mediators known to skew differentiation of monocytes to tumor-promoting M2 macrophages. We investigated the impact of cisplatin and carboplatin on 10 different cervical and ovarian cancer cell lines as well as on the ability of the tumor cells to affect the differentiation and function of cocultured monocytes in vitro. Treatment with cisplatin or carboplatin increased the potency of tumor cell lines to induce IL-10-producing M2 macrophages, which displayed increased levels of activated STAT3 due to tumor-produced IL-6 as well as decreased levels of activated STAT1 and STAT6 related to the PGE 2 production of tumor cells. Blockade of canonical NF-kB signaling showed that the effect of the chemotherapy was abrogated, preventing the subsequent increased production of PGE 2 and/or IL-6 by the tumor cell lines. Treatment with the COX-inhibitor indomethacin and/or the clinical monoclonal antibody against interleukin-6 receptor (IL-6R), tocilizumab, prevented M2-differentiation. Importantly, no correlation existed between the production of PGE 2 or IL-6 by cancer cells and their resistance to chemotherapy-induced cell death, indicating that other mechanisms underlie the reported chemoresistance of tumors producing these factors. Our data suggest that a chemotherapy-mediated increase in tumor-promoting M2 macrophages may form an indirect mechanism for chemoresistance. Hence, concomitant therapy with COX inhibitors and/or IL-6R antibodies might increase the clinical effect of platinum-based chemotherapy in otherwise resistant tumors. Cancer Res; 73(8); 2480-92. Ó2013 AACR.

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Maintenance chemotherapy for ovarian cancer

Cited by 33 publications

References 12 publications

Assessment of prognostic factors in epithelial ovarian cancer

Assessment of prognostic factors in epithelial ovarian cancer

Ovarian cancer

Chemotherapy Alters Monocyte Differentiation to Favor Generation of Cancer-Supporting M2 Macrophages in the Tumor Microenvironment

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