Commentary: Planning Treatment for Women With Recurrent Epithelial Ovarian Cancer - Cancer Network

Cancer Network

COMMENTARY

Planning Treatment for Women With Recurrent Epithelial Ovarian Cancer

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Optimal management of recurrent ovarian cancer remains an area of uncertainty. Unlike many other solid tumors with few salvage agents to choose from, a variety of regimens have demonstrated at least modest efficacy. How is an oncologist to develop an optimal treatment plan given the available options? In this issue of ONCOLOGY, Foley and colleagues present a comprehensive review of systemic therapies available to treat patients with recurrent ovarian cancer.[1] They include a discussion of standard options, new chemotherapeutics, and biologic agents. Despite a thorough cataloging of available regimens, the authors rightly note that the process of deciding which agent to use in a particular patient remains highly individualized. In fact, most patients receive several (if not all) available salvage chemotherapy regimens in a variety of sequences. Unfortunately, we still do not have clear-cut data-driven pathways to guide treatment choices once recurrent disease develops.
One factor that clearly aids treatment planning in patients with recurrent ovarian cancer is determining the primary progression-free interval (PFI). As described in the review by Foley et al, patients can be divided into those who are platinum-sensitive (PFI > 6 months) vs platinum-resistant (PFI ≤ 6 months)...........

This commentary refers to the following article

Recurrent Epithelial Ovarian Cancer: An Update on Treatment

References

1. Foley OW, Rauh-Hain JA, del Carmen MG: Recurrent epithelial ovarian cancer: an update on treatment. Oncology (Williston Park). 2013;27:288-98.
2. Chi DS, McCaughty K, Diaz JP, et al Guidelines and selection criteria for secondary cytoreductive surgery in patients with recurrent, platinum-sensitive epithelial ovarian carcinoma. Cancer. 2006;106:1933-9.
3. Salani R, Santillan A, Zahurak ML, et al. Secondary cytoreductive surgery for localized, recurrent epithelial ovarian cancer: analysis of prognostic factors and survival outcome. Cancer. 2007;109:685-91.
4. Gadducci A, Cosio S, Zola P, et al. Prognostic factors and clinical outcome of patients with recurrent early-stage epithelial ovarian cancer: an Italian multicenter retrospective study. Int J Gynecol Cancer. 2013;23:461-8.
5. Aghajanian C, Blank SV, Goff BA, et al. OCEANS: a randomized, double-blind, placebo-controlled phase III trial of chemotherapy with or without bevacizumab in patients with platinum-sensitive recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer. J Clin Oncol. 2012;30:2039-45.
6. Gelmon KA, Tischkowitz M, Mackay H, et al. Olaparib in patients with recurrent high-grade serous or poorly differentiated ovarian carcinoma or triple-negative breast cancer: a phase 2, multicentre, open-label, non-randomised study. Lancet Oncol. 2011;12:852-61.