Ovarian cancer: Current status and strategies for improving therapeutic outcomes (original) (raw)
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Clinical Ovarian Cancer, 2010
Epithelial ovarian cancer is the leading cause of death from gynecologic malignancies in the United States. Although the prevalence of ovarian cancer when compared with other neoplasms is low, with an estimated 21,550 new cases in 2009, the majority of patients are diagnosed at an advanced stage of disease, with projected 5-year relative sur-r r vival rates of 31%. Early detection is a clinically relevant goal for the optimal management of patients with ovarian cancer. Attempts to develop valuable screening strategies and incorporate preventive measures are ongoing. Frontline management of ovarian cancer involves primary cytoreductive surgery followed by platinum-based combination chemotherapy and up to 80% of women with advanced disease achieve an objective response and 10%-20% are cured with this regimen; nevertheless, disease recurrence is inevitable in most patients. Multiple strategies including the inclusion of effective targeted therapies upfront and the incorporation of maintenance regimens are being investigated to improve frontline response rates. Currently, the choice of treatment in recurrent ovarian cancer is based on the disease-free interval from completion of first-line platinum-based therapy; several platinum and non-platinum agents are used in the recurrent setting with equivalent efficacy outcomes. The roles of targeted therapies, secondary cytoreductive surgery, and rising cancer antigen 125 levels in the treatment of recurrent disease are being delineated. Clearly, there is a need to identify novel agents and personalized strategies that will improve clinical outcomes in this disease. It is likely that a better understanding of the molecular changes in the pathogenesis of ovarian cancer will pave the way for more effective therapeutic options. This summary highlights current challenges in the management of ovarian cancer and outlines expert perspectives, key questions, and future directions.
Actualities in Ovarian Cancer in the Perspective of 2015 (ASCO and ECCO)
2016
Ovarian cancer represents the 4-th reason of cancer related death in women, the majority of patients being diagnosed in advanced stages of the disease, (III-IV). The loco-regional advanced ovarian cancer should be considered a chronic disease, with multiple evolutionary relapses and where the adjuvant treatment is mandatory.The treatment of the disease is multidisciplinary and the oncologist is the centerpiece.
Ovarian cancer – where are we today?
Romanian Journal of Medical Practice
Despite progress reported in terms of paraclinical tests and imagistic studies, ovarian cancer represents one of the most lethal malignancies affecting women worldwide. Therefore attention was focused on identifying new prognostic markers in order to better identify candidates for primary cytoreductive surgery versus interval debulking surgery. Moreover, the wide introduction of the concept of personalized medicine gave the opportunity to benefit from more targeted treatments according to each patient needs and particularities. This is a literature review of the current status of ovarian cancer worldwide.
Latest research and treatment of advanced-stage epithelial ovarian cancer
Nature Reviews Clinical Oncology, 2013
The natural history of ovarian cancer continues to be characterized by late-stage presentation, metastatic bulky disease burden and stagnant mortality statistics despite prolific drug development. Robust clinical investigation, particularly with modifications to primary treatment surgical goals and adjuvant therapy are increasing median progression-free and overall survival, although the cure rates have only modestly been affected. Maintenance therapy holds promise, but studies have yet to identify an agent and/or strategy that can affect survival. Recurrent disease is largely an incurable state; however, current intervention with selected surgery, combination and targeted therapy and investigational protocols are impacting progression-free survival. Ovarian cancer is a diverse and genomically complex disease, which commands global attention. Rational investigation must balance the high rate of discovery with lagging clinical investigation and limited patient resources. Nevertheless, armamentarium growth offers unprecedented opportunities for patients suffering with this disease. This Review presents and reviews the contemporary management of the disease spectrum termed epithelial 'ovarian' cancer and introduces the direction and early results of clinical investigation.
The detection, treatment, and biology of epithelial ovarian cancer
Journal of ovarian research, 2010
Ovarian cancer is particularly insidious in nature. Its ability to go undetected until late stages coupled with its non-descript signs and symptoms make it the seventh leading cause of cancer related deaths in women. Additionally, the lack of sensitive diagnostic tools and resistance to widely accepted chemotherapy regimens make ovarian cancer devastating to patients and families and frustrating to medical practitioners and researchers. Here, we provide an in-depth review of the theories describing the origin of ovarian cancer, molecular factors that influence its growth and development, and standard methods for detection and treatment. Special emphasis is focused on interactions between ovarian tumors and the innate and adaptive immune system and attempts that are currently underway to devise novel immunotherapeutic approaches for the treatment of ovarian tumors.
Ovarian carcinoma: An overview of current status
Advances in Modern Oncology Research, 2016
Ovarian carcinoma is one of the leading causes of morbidity and mortality associated with carcinomas affecting women. It comprises a heterogeneous group of neoplasms that represents the seventh most lethal malignancy in women worldwide, and is a major cause of death from gynecological carcinoma. Specific to different geographical locations all over the globe, there are variations in the magnitude and trends of ovarian carcinoma, and the scenario of the disease keeps changing. As such, it is necessary to update and review the existing study on ovarian carcinoma. Reviews on ovarian carcinoma from 2000 to 2015 were extracted from PubMed and Google Scholar, and a few selected landmark studies that incorporated old data were also included. The focus of the present study is to consolidate an updated global view on epithelial ovarian carcinoma, the most prevalent type of ovarian carcinoma. This article covers the epidemiology, types, diagnosis, prognosis, and treatment of epithelial ovarian carcinoma.
Cancer, 2019
Substantial progress has been made in understanding ovarian cancer at the molecular and cellular level. Significant improvement in 5-year survival has been achieved through cytoreductive surgery, combination platinum-based chemotherapy, and more effective treatment of recurrent cancer, and there are now more than 280,000 ovarian cancer survivors in the United States. Despite these advances, long-term survival in late-stage disease has improved little over the last 4 decades. Poor outcomes relate, in part, to late stage at initial diagnosis, intrinsic drug resistance, and the persistence of dormant drug-resistant cancer cells after primary surgery and chemotherapy. Our ability to accelerate progress in the clinic will depend on the ability to answer several critical questions regarding this disease. To assess current answers, an American Association for Cancer Research Special Conference on "Critical Questions in Ovarian Cancer Research and Treatment" was held in Pittsburgh, Pennsylvania, on October 1-3, 2017. Although clinical, translational, and basic investigators conducted much of the discussion, advocates participated in the meeting, and many presentations were directly relevant to patient care, including treatment with poly adenosine diphosphate ribose polymerase (PARP) inhibitors, attempts to improve immunotherapy by overcoming the immune suppressive effects of the microenvironment, and a better understanding of the heterogeneity of the disease.
Ovarian Cancer: Biomarkers and Targeted Therapy
Biomedicines
Ovarian cancer is one of the most common causes of death in women as survival is highly dependent on the stage of the disease. Ovarian cancer is typically diagnosed in the late stage due to the fact that in the early phases is mostly asymptomatic. Genomic instability is one of the hallmarks of ovarian cancer. While ovarian cancer is stratified into different clinical subtypes, there still exists extensive genetic and progressive diversity within each subtype. Early detection of the disorder is one of the most important steps that facilitate a favorable prognosis and a good response to medical therapy for the patients. In targeted therapies, individual patients are treated by agents targeting the changes in tumor cells that help them grow, divide and spread. Currently, in gynecological malignancies, potential therapeutic targets include tumor-intrinsic signaling pathways, angiogenesis, homologous-recombination deficiency, hormone receptors, and immunologic factors. Ovarian cancer is ...