Ovarian cancer treatment: what is new

Abstract

Ovarian cancer is still the fourth cause of death by cancer among women and the most fatal among gynecological tumors. The purpose of this symposium is, year after year, to report and discuss the new developments in the treatment of patients with ovarian cancer, the majority of whom still present with advanced disease. It also tries to make it clear to the participants what is evidence-based and what is not. Mature data of both classic studies like GOG-111, OV-10, and more recent studies like GOG-158, AGO-OVAR-3, and the intergroup paclitaxel/epirubicin/carboplatin (TEC) versus paclitaxel/carboplatin (TC) study have been presented. Other current controversial issues included in this edition were sequential single-agent versus simultaneous administration of combination chemotherapy, the role of combination chemotherapy in second-line treatment, the role of consolidation therapy, the role of anthracyclines in the treatment, and cost-effectiviness studies in ovarian cancer. Although the main topic of the symposium is advanced disease, this edition included the results of two parallel randomized studies (ACTION and ICON1) on the treatment of early disease. In addition, new trends in early detection of ovarian cancer have been updated.The pace of new agent development has increased, and it would be helpful to have more efficient preclinical models and early phase-clinical trials to guide the selection of active agents for phase III evaluation. Reaching international consensus is a challenge but offers the opportunity to test multiple regimens more efficiently against a single-control population, rather than conducting multiple smaller studies with redundant internal controls. If indeed answers to the relevant questions are to be obtained more quickly, then, a network of current national or international groups could potentially facilitate this.

Ovarian cancer: is the news good enough?

“…As we presented 2 years ago (4) , OC can be detected in asymptomatic women using a variety of screening tests (6) . Serum CA125 is the most extensively evaluated tumor marker for OCS.…”

“…Standard chemotherapy for OC in 2005 should consist of a platinum compound (usually carboplatin) and a taxane (usually paclitaxel) (4,5,21) .…”

“…The development of molecular biology is also providing us with new information not only on mechanisms resistant to drugs of regular use for the treatment of OC but also in understanding OC initiation and progression (4) .…”

“…And the second reason is technical facts: only 35% of patients undergo an optimal debulking surgery. This is influenced by the extension of the disease and the surgeon's experience (3,4) .…”

Adjuvant whole abdominal intensity modulated radiotherapy (IMRT) for high risk stage FIGO III patients with ovarian cancer (OVAR-IMRT-01) – Pilot trial of a phase I/II study: study protocol

“…By now, several sometimes randomized trials have evaluated strategies of consolidation therapy for high risk patients (continuation of chemotherapy, other chemotherapy, high-dose chemotherapy followed by stem cell transplant, intraperitoneal chemotherapy, unspecific immunotherapy) but were not able to improve outcome significantly so far [ 5 , 9 , 10 , 15 - 17 ].…”