Systemic therapy for gynecologic cancer.

Several provocative studies in gynecologic cancer were recently presented. Long-term follow-up of ovarian cancer patients has confirmed the clinical impression of a low survival. Novel classes of active chemotherapeutics are the second-generation topoisomerase I inhibitors, irinotecan (CPT-11) and topotecan, and the taxanes, Taxol (Bristol-Meyers, Wallingford, CT) and Taxotere (Rhone-Poulenc Rorer, Antony, France). Dose intensity remains an intriguing issue. Biologic agents, including monoclonal antibodies, are being developed for palliation of ascites. In cervical cancer, use of retinoids and interferons has opened up a new avenue of investigation. Use of the World Health Organization sophisticated scoring criteria has improved the primary treatment of trophoblastic disease. Advances in salvage therapy have been noted. Progress in the treatment of advanced endometrial cancer and uterine sarcomas is beginning.