Update on the Prevention and Treatment of Ovarian Cancer

Abstract

Ovarian cancer is the fourth leading cause of cancer among women and the number one gynecologic fatality. The etiology of ovarian cancer is still an enigma. Three common hypotheses under investigation include the ovulation, the pituitary gonadotropin, and the chronic inflammatory processes. Chemoprevention strategies used for ovarian cancer include oral contraceptives, aspirin and nonsteroidal anti-inflammatory agents, and retinoids. Surgical strategies are also used in the prevention of ovarian cancer. The primary treatment for patients with ovarian cancer is surgery with optimal tumor debulking, and for patients with advanced disease, this is followed by adjuvant chemotherapy. The standard practice is to follow surgery with six cycles of paclitaxel plus carboplatin. The second-line chemotherapy agents have had minimal long-term benefit for treating ovarian cancer. Hence, treatment with investigational agents remains the best option for patients with recurrent disease due to lack of alternative curative treatment.

Epithelial Ovarian Cancer: Disease Etiology, Treatment, Detection, and Investigational Gene, Metabolite, and Protein Biomarkers

“…Several drugs have been approved by the FDA for epithelial ovarian cancer treatment, spanning a variety of therapeutic options. The standard care for EOC patients involves staging and cytoreduction surgery followed by chemotherapy with a platinum and taxane combination …”

“…Indeed, successful cytoreduction surgery that decreases tumor size to less than 1 cm (<2%) residual disease can significantly increase overall survival of epithelial ovarian cancer patients . For individuals with Stage I, II, or III EOC, well-established surgical plans include, but are not limited to, total abdominal hysterectomy (removal of the uterus), infracolic omentectomy (excision of the omentum beneath the transverse colon), bilateral salpingooophorectomy (removal of fallopian tubes and ovaries), and lymph-adenectomy (lymph node dissection). , …”

“…First-line chemotherapy (Table S4, Supporting Information) usually involves a combination of Carboplatin and Paclitaxel …”

“…Paclitaxel acts through hyperstabilization of microtubules, thus compromising flexibility of the cellular cytoskeleton. Although other options are available for first-line therapy for epithelial ovarian cancer, the combination of Carboplatin and Paclitaxel is preferred due to milder side effects and more facile administration …”

“…The choice for second-line chemotherapy regimes differ greatly from patient to patient (Table S4, Supporting Information). If the patient is thought to have platinum-sensitive disease, she has a more positive prognosis and can chose from more cytotoxic platinum drugs such as Cisplatin, Cyclophosphamide, and Docetaxel …”