Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, Alvin J. Siteman Cancer Center, St Louis, MO, United States of America.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, Alvin J. Siteman Cancer Center, St Louis, MO, United States of America.
Gynecol Oncol. 2019 Feb;152(2):416-425. doi: 10.1016/j.ygyno.2018.10.023. Epub 2018 Nov 5.
Epithelial ovarian cancer (EOC) is the leading cause of death due to gynecologic malignancy. The majority of advanced stage EOC patients, even those who respond well to frontline therapy, will ultimately recur and succumb to their disease. In platinum-sensitive EOC patients, or those who recur ≥6 months from initial diagnosis, treatment of recurrent disease has traditionally consisted of repeat platinum-based chemotherapy. Secondary cytoreduction remains controversial. Due to recent advances in molecularly targeted treatment options, outcomes for advanced stage EOC patients are significantly improving and hold great promise. This review discusses pivotal trials establishing platinum-based combination chemotherapy as the standard of care and addresses the utility of increasing a patient's platinum-free interval. It then discusses the role of anti-angiogenesis therapeutics, specifically bevacizumab, cediranib, and trebananib and their side effects. Lastly, it reviews key trials for the three poly-adenosine diphosphate [ADP]-ribose polymerases (PARP) inhibitors that have been FDA-approved for maintenance therapy in platinum-sensitive recurrent EOC: olaparib, rucaparib, and niraparib. This review concludes with a discussion regarding ongoing and future clinical trials.
上皮性卵巢癌（EOC）是妇科恶性肿瘤导致死亡的主要原因。大多数晚期 EOC 患者，即使对一线治疗反应良好，最终仍会复发并死于疾病。在铂类敏感的 EOC 患者中，或那些在初始诊断后≥6 个月复发的患者中，复发性疾病的传统治疗方法是重复铂类化疗。二次细胞减灭术仍存在争议。由于近年来分子靶向治疗选择的进步，晚期 EOC 患者的预后得到了显著改善，前景广阔。这篇综述讨论了确立铂类联合化疗作为标准治疗的关键试验，并探讨了增加患者无铂间期的效用。然后讨论了抗血管生成治疗药物，特别是贝伐单抗、西地尼布和替拉那尼布及其副作用。最后，回顾了三种已被美国食品药品监督管理局（FDA）批准用于铂类敏感复发性 EOC 维持治疗的多聚腺苷二磷酸[ADP]-核糖聚合酶（PARP）抑制剂奥拉帕利、鲁卡帕利和尼拉帕利的关键试验。本文最后讨论了正在进行和未来的临床试验。
