First-Line and Maintenance Therapy for Ovarian Cancer: Current Status and Future Directions

• Published in: Drugs (New York, N.Y.) Vol. 74; no. 8; pp. 879 - 889
• Main Authors: González-Martín, Antonio, Sánchez-Lorenzo, Luisa, Bratos, Raquel, Márquez, Raúl, Chiva, Luis
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2014; Adis International; Springer Nature B.V
• Subjects: Angiogenesis Inhibitors - pharmacology; Angiogenesis Inhibitors - therapeutic use; Antibodies, Monoclonal, Humanized - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - pharmacology; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bevacizumab; Biological and medical sciences; Carboplatin - administration & dosage; Carcinoma, Ovarian Epithelial; Disease-Free Survival; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Internal Medicine; Medical sciences; Medicine; Medicine & Public Health; Molecular Targeted Therapy; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoplasms, Glandular and Epithelial - drug therapy; Neoplasms, Glandular and Epithelial - pathology; Ovarian cancer; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - pathology; Paclitaxel - administration & dosage; Pharmacology/Toxicology; Pharmacotherapy; Protein Kinase Inhibitors - pharmacology; Protein Kinase Inhibitors - therapeutic use; Review Article; Tumors; Ovarian Cancer; Overall Survival; Sorafenib; Paclitaxel; Bevacizumab; Ovarian diseases; Ovary cancer; Maintenance treatment; Malignant tumor; Review; Cancer; Female genital diseases; First line treatment
• ISSN: 0012-6667; 1179-1950
• DOI: 10.1007/s40265-014-0221-9

Paclitaxel and carboplatin combination chemotherapy has remained the standard of care in the frontline therapy of advanced epithelial ovarian carcinoma during the last decade. Maintenance chemotherapy or immunotherapy has not been proven to impact on overall survival and only one clinical trial that explored the administration of monthly paclitaxel for 1 year showed a benefit in terms of progression-free survival (PFS), but at the cost of maintained alopecia and increased peripheral neuropathy. This scenario may be changing with the incorporation of targeted therapy to the frontline therapy of ovarian cancer. In particular, anti-angiogenic therapy has been identified as the most promising targeted therapy, and the addition of bevacizumab to first-line chemotherapy followed by a maintenance period of bevacizumab in monotherapy has shown to prolong PFS. This was considered the proof of concept of the value of anti-angiogenic therapy in the frontline of ovarian cancer, and the results of two additional clinical trials with anti-angiogenic tyrosine-kinase inhibitors have shown results in the same direction.