Ovarian cancer: progress and continuing controversies in management

摘要: Abstract Ovarian cancer is the most lethal of gynaecological cancers, affecting approximately 1 in 75 women developed world. In cases (>75%), disease disseminated beyond ovary at diagnosis. For patients with stage III–IV disease, many clinicians agree that standard treatment should comprise six cycles paclitaxel–carboplatin. Randomised trials over past 10 years have indicated superiority paclitaxel-based and carboplatin equivalent to cisplatin, but better tolerated. A recent trial has suggested docetaxel may be a option than paclitaxel, reduced neurotoxicity comparable efficacy. Overall results remain unsatisfactory, since median survival for these 2–3 years. Future progress made by addressing following issues: Would sequential regimes more effective? Intriguing from two large randomised (ICON-3 GOG-132) indicate single agent platinum might well incorporated into such regimes. Additionally, range other agents could tested as part first-line regimes, having demonstrated activity relapsed patients; include topotecan, gemcitabine liposomal doxorubicin. Newer agents, cell signalling inhibitors shown potential particularly effective combination current drugs. Real can expected when understanding achieved mechanisms underlying clinical drug resistance ovarian cancer, close laboratory–clinical interaction crucial.