Oronsky Bryan, Ray Carolyn M, Spira Alexander I, Trepel Jane B, Carter Corey A, Cottrill Hope M
EpicentRx Inc, 4445 Eastgate Mall, Suite 200, San Diego, CA, 92121, USA.
Saint Francis Medical Group, Hartford, CT, USA.
Med Oncol. 2017 Jun;34(6):103. doi: 10.1007/s12032-017-0960-z. Epub 2017 Apr 25.
Ovarian cancer, which ranks fifth in cancer deaths among women, is the most lethal gynecologic malignancy. Epithelial ovarian cancer (EOC) is the most common histologic type, with the 5-year survival for all stages estimated at 45.6%. This rate increases to more than 70% in the minority of patients who are diagnosed at an early stage, but declines to 35% in the vast majority of patients diagnosed at advanced stage. Recurrent EOC is incurable. Platinum sensitivity (or lack thereof) is a major determinant of prognosis. The current standard treatment is primary surgery followed by platinum-based chemotherapy. In recurrent platinum-resistant/platinum-refractory EOC, sequential single-agent salvage chemotherapy is superior to multiagent chemotherapy. Multiagent regimens increase toxicity without clear benefit; however, no preferred sequence of single agents is recommended. The impact of targeted therapies and immunotherapies on progression-free survival and overall survival, which remains dismal, is under active investigation. Currently, clinical trials offer the best hope for the development of a new treatment paradigm in this recalcitrant disease.
卵巢癌是最致命的妇科恶性肿瘤，在女性癌症死亡原因中排名第五。上皮性卵巢癌（EOC）是最常见的组织学类型，所有阶段的5年生存率估计为45.6%。在少数早期诊断的患者中，这一比例升至70%以上，但在绝大多数晚期诊断的患者中降至35%。复发性EOC无法治愈。铂敏感性（或缺乏铂敏感性）是预后的主要决定因素。目前的标准治疗是初次手术，随后进行铂类化疗。在复发性铂耐药/铂难治性EOC中，序贯单药挽救化疗优于多药化疗。多药方案增加了毒性但没有明显益处；然而，不推荐单药的首选顺序。靶向治疗和免疫治疗对无进展生存期和总生存期的影响仍然不佳，目前正在积极研究中。目前，临床试验为这种难治性疾病开发新的治疗模式提供了最大希望。
