Emerging treatment strategies in recurrent platinum-sensitive ovarian cancer: focus on trabectedin.

Abstract

Ovarian cancer (OC) is the leading cause of death from gynecological malignancies. In spite of high response rates to the standard front-line treatment for advanced disease with cytoreductive surgical debulking, followed by platinum/taxane-based chemotherapy, most patients eventually relapse developing drug-resistant disease. Owing to the molecular heterogeneity, genetic instability and mutagenicity of OC, increases in survival might be achieved by translating recent insights at the morpho-molecular levels to individual therapeutic strategies. Several emerging treatments have been shown to be active in platinum-sensitive (PS) recurrent OC (ROC), but an optimal strategy still has not been established. Based on the recent results, it is likely that the introduction of novel non-platinum based chemotherapies and molecular targeted therapies will have a major impact on the management of ROC. Some current strategies are focused on the extension of platinum-free interval (PFI) in patients with PS, particularly in those with partially PS disease. Apparently, the PFI extension by an effective non-platinum intervention, such as trabectedin plus pegylated liposomal doxorubicin (PLD), may reduce cumulative platinum-induced toxicities leading to longer survival after the reintroduction of subsequent platinum. The introduction of novel therapies, such as the antiangiogenic monoclonal antibody bevacizumab, opens a new field of targeted therapies in this indication. In this review, we aim to outline the therapeutic potential of new emerging approaches, particularly the role of non-platinum therapy with trabectedin in combination with PLD in patients with PS ROC.

• Authors: Andrés Poveda, Isabelle Ray-Coquard, Ignacio Romero, Jose Antonio Lopez-Guerrero, Nicoletta Colombo
• Journal: Cancer treatment reviews (Cancer Treat Rev) Vol. 40 Issue 3 Pg. 366-75 (Apr 2014) ISSN: 1532-1967 [Electronic] Netherlands
• PMID: 24296108 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Chemical References

• Antineoplastic Agents, Alkylating
• Dioxoles
• Platinum Compounds
• Tetrahydroisoquinolines
• Trabectedin

Topics

• Antineoplastic Agents, Alkylating (therapeutic use)
• Dioxoles (therapeutic use)
• Female
• Humans
• Neoplasm Recurrence, Local (drug therapy)
• Ovarian Neoplasms (drug therapy)
• Platinum Compounds (therapeutic use)
• Practice Guidelines as Topic
• Tetrahydroisoquinolines (therapeutic use)
• Trabectedin