Treatment for Recurrent Ovarian Cancer—At First Relapse

Abstract

Recurrent ovarian cancer is a lethal disease, and few patients can be cured. Although most patients receive standardized surgery and chemotherapy, the status of recurrent disease is heterogeneous. The site of recurrence and the survival intervals after recurrence are also widely distributed. Among a number of factors, many clinical trials identified time to recurrence was the factor most related to chemosensitivity at first relapse. The current recommendation for platinum sensitive ovarian cancer is a carboplatin containing combination chemotherapy. Generally, a single agent is chosen for platinum resistant ovarian cancer. Patients with single site recurrence and a long disease free interval are candidates for secondary cytoreduction, which may provide longer survival. There are several treatment choices at first relapse, and disease status, chemotherapy-free interval, and the patient's condition play a major role in the decision making process.

The C-terminal fragment of the immunoproteasome PA28S (Reg alpha) as an early diagnosis and tumor-relapse biomarker: evidence from mass spectrometry profiling

“…The C-terminal Reg-alpha fragment (m/z 9,744) is detected in the OVC cells. The inset shows the hematoxylin and eosin (H&E) staining of the tissue subjected to MALDI-MS profiling analyses (scale bar 5 mm) a paclitaxel and carboplatin combination for sensitive (6 months) patients is currently used after phase I (Ushijima 2010). Patients with persistent ovarian cancer have cancer cells that are detected after initial surgery and first-line chemotherapy.…”

The optimal time for surgery in women with serous ovarian cancer

“…It is well known that patients with platinumresistant disease have significantly worse survival. 6,7 In this study, patients with platinum-sensitive disease had worse overall and progression-free survival when treated with neoadjuvant chemotherapy than with primary surgery. Importantly, these differences remained significant after adjusting for confounding factors, including age, debulking status and sensitivity to platinum-based chemotherapy.…”

“…4,5 However, despite aggressive surgery and chemotherapy, cure is rare for the majority of women with HGSC. Survival in these patients largely depends on the tumour sensitivity to platinum-based chemotherapy 6,7 and the degree of surgical cytoreduction. 8,9 Even extensive surgeries leaving more than 1 cm of residual tumour have limited impact on survival.…”

The future for follow-up of gynaecological cancer in Europe. Summary of available data and overview of ongoing trials

“…About 70% of patients with ovarian cancer are diagnosed in advanced stage and about 70% of these will relapse [40]. The tumour marker CA125 is superior to all other tumour markers in the detection of early recurrence in ovarian cancer.…”