Medical Oncology Department, MD Anderson Cancer Center, C/Arturo Soria 270, 28033, Madrid, Spain,
Drugs. 2014 Jun;74(8):879-89. doi: 10.1007/s40265-014-0221-9.
Paclitaxel and carboplatin combination chemotherapy has remained the standard of care in the frontline therapy of advanced epithelial ovarian carcinoma during the last decade. Maintenance chemotherapy or immunotherapy has not been proven to impact on overall survival and only one clinical trial that explored the administration of monthly paclitaxel for 1 year showed a benefit in terms of progression-free survival (PFS), but at the cost of maintained alopecia and increased peripheral neuropathy. This scenario may be changing with the incorporation of targeted therapy to the frontline therapy of ovarian cancer. In particular, anti-angiogenic therapy has been identified as the most promising targeted therapy, and the addition of bevacizumab to first-line chemotherapy followed by a maintenance period of bevacizumab in monotherapy has shown to prolong PFS. This was considered the proof of concept of the value of anti-angiogenic therapy in the frontline of ovarian cancer, and the results of two additional clinical trials with anti-angiogenic tyrosine-kinase inhibitors have shown results in the same direction.
紫杉醇和卡铂联合化疗在过去十年中一直是晚期上皮性卵巢癌一线治疗的标准治疗方法。维持化疗或免疫治疗并未证明能影响总生存期，只有一项临床试验探索了每月给予紫杉醇治疗 1 年，显示在无进展生存期（PFS）方面有获益，但代价是保持脱发和增加周围神经病变。这种情况可能随着将靶向治疗纳入卵巢癌的一线治疗而发生改变。特别是，抗血管生成治疗已被确定为最有前途的靶向治疗，贝伐珠单抗联合一线化疗后序贯贝伐珠单抗单药维持治疗已显示可延长 PFS。这被认为是抗血管生成治疗在卵巢癌一线治疗中价值的概念验证，另外两项抗血管生成酪氨酸激酶抑制剂的临床试验结果也显示出了相同的方向。
