Target Therapy in Platinum-Refractory/Resistant Ovarian Cancer: From Preclinical Findings to Current Clinical Practice

Abstract

Epithelial ovarian cancer (EOC) is the sixth most common malignancy in women. Ovarian tumors consist of several clinical and pathological entities that share an anatomic site. The gold standard treatment, both in front-line and in adjuvant setting, is represented by carboplatin/paclitaxel combination. Conversely, the second-line treatment is not well defined. The response to platinum is the major prognostic factor for survival. In this review we discuss the current views on platinum-refractory/resistant patient treatment only, which includes patients progressing or relapsing within 6 months from the last platinum-based course. Concerning this subgroup, the activity of several conventional drugs was confirmed in different trials without a significant impact in terms of overall survival. In the last years particular emphasis was given to targeted anti-angiogenetic therapy which produced a survival improvement with an acceptable toxicity profile. New "ad hoc" approaches, with a major attention to outcome-predictive factors, are eagerly awaited.

Is ovarian cancer a targetable disease? A systematic review and meta-analysis and genomic data investigation

“…These findings indicate the occurrence of a class effect at meta-analytic evaluation and provide proof of concept for novel biomarker driven investigation. In our opinion the most interesting finding is the significant PFS benefit in platinum-resistant setting that underscored the importance of this class of drugs, in particular anti-angiogenic agents, in a subgroup with poor prognosis, considered resistant to conventional systemic treatment or surgery [ 8 , 61 ]. As mainly reported in the AURELIA trial, we show that the addition of anti-angiogenetic agents to standard chemotherapy produces significant benefits, particularly in combination with paclitaxel [ 10 ].…”