Section Review: Oncologic, Endocrine & Metabolic: Treatments, topics, and trends in ovarian cancer

Abstract

Long-term survival is now a reality for patients diagnosed with advanced ovarian cancer. Although cisplatin-based chemotherapy has been the standard therapy for the 1990s, new data suggest that combination chemotherapy, including initial treatment with pacli-taxel, is superior to cisplatin/cyclophosphamide. Other areas of progress include the use of the tumour marker, CA125, the recognition of prognostic factors, the impact of dose, intraperitoneal treatment, the role of surgery, and new drugs. However, many questions are unresolved. For example, what is the best dose and scheduling of paclitaxel? Is it better to treat recurrent disease as soon as possible or to wait until symptoms occur? What will be the new standard chemotherapy in the next decade? What is the best end-point for future clinical trials? These are questions that can only partly be answered from the literature; the final answer will come from performing the necessary trials. A number of new agents with activity during platinum therapy in patients with progressive disease have recently become available, including docetaxel, 2′,2′-difluorodeoxy-cytidine, topoisomerase I inhibitors, and lobaplatin. The results of studies with these drugs will certainly have an impact on future clinical practice and research.