Optimizing regional chemotherapy for epithelial ovarian cancer

Abstract

Aim The response with intravenous chemotherapy using cisplatin and paclitaxel in patients with advanced ovarian cancer is often substantial. However, this regression of the malignancy is not durable, and a majority of patients succumb to this disease process. It is possible that alternative types of chemotherapy and alternative routes of chemotherapy administration can improve the results of treatment and perhaps, reduce the morbidity and mortality that patients experience. Methods Regional chemotherapy treatments previously presented in the ovarian cancer literature were reviewed and critically analyzed. New methods for chemotherapy delivery for both advanced primary and recurrent ovarian cancer were reviewed. This included hyperthermic intraperitoneal chemotherapy (HIPEC), early postoperative intraperitoneal chemotherapy (EPIC), and normothermic intraperitoneal chemotherapy (NIPEC) long‐term. Results An important addition to perioperative chemotherapy delivery is the simultaneous use of heat with intraperitoneal drug delivery after a complete cytoreductive surgery. Drugs to be considered for HIPEC are cisplatin, gemcitabine, and melphalan. For EPIC, chemotherapy agents to consider include paclitaxel, pemetrexed, gemcitabine, and liposomal doxorubicin. For NIPEC, paclitaxel is the drug of choice usually combined with a systemic agent as bidirectional chemotherapy. Also, pemetrexed, gemcitabine, and liposomal doxorubicin are drugs to be considered for NIPEC in phase I/II trials. Conclusions Innovative regimens of regional chemotherapy may improve the outcome of patients with advanced ovarian cancer. These chemotherapy treatments must be integrated with complete cytoreductive surgery and the availability of peritoneal access for repeated delivery of chemotherapy solutions.

A Human Ovarian Tumor & Liver Organ-on-Chip for Simultaneous and More Predictive Toxo-Efficacy Assays

“…Surprisingly, these results suggest that multi-organ and dynamic 3D culture are more predictive than the traditional static models, considering the wide use of this chemotherapeutic drug for treating women affected by ovarian cancer [58][59][60][61][62]. Moreover, it is worth discussing the experimental setting that we used in the dynamic multi-organ assay.…”

Synergistic Effects of Chemotherapy and Phototherapy on Ovarian Cancer Using Follicle-Stimulating Hormone Receptor-Mediated Liposomes Co-Loaded with SN38 and IR820

“…The membranes were incubated overnight at 4 °C with AC-TIN (GB12001, Servicebio, Beijing, China) and FSHR antibodies (1:1000; 2808s, Cell Signaling, Shanghai, China). Following washing, the membranes were incubated with goat anti-rat IgG antibody for 1 h, and observed using a chemiluminescence (ImageQuant LAS 4000 mini, Fuji, Japan) [ 7 , 9 , 10 , 11 , 18 ].…”

“…At present, the first-line chemotherapy drug for ovarian cancer is platinum plus paclitaxel, but due to the resistance and high recurrence rate of platinum plus paclitaxel, many patients cannot receive effective treatment [ 6 ]. Perhaps choosing different types of chemotherapy and chemotherapy administration methods can improve treatment efficacy and reduce patient recurrence and mortality rates [ 7 ]. However, many chemotherapy drugs have poor molecular water solubility, short circulating half-life, and severe cytotoxicity to healthy organs, which limits their clinical application.…”