Journal
CLINICAL OBSTETRICS AND GYNECOLOGY
Volume 55, Issue 1, Pages 96-113Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/GRF.0b013e31824b45da
Keywords
ovarian carcinoma; carboplatin; chemotherapy; angiogenesis; dose-density; chemotherapy resistance
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Advanced-stage epithelial ovarian cancer remains a highly lethal malignancy, despite effective cytoreductive surgery and primary chemotherapy. Phase III studies have evaluated multidrug combinations, dose-dense weekly scheduling, intraperitoneal delivery, neoadjuvant chemotherapy, maintenance therapy, and targeting of angiogenesis. Incremental gains in median progression-free or overall survival have been achieved, but without an impact on overall mortality. Data support intraperitoneal cisplatin, dose-dense weekly paclitaxel, or neoadjuvant chemotherapy with interval cytoreduction in appropriate patients. Encouraging data have emerged using anti-angiogenic agents, but with questions regarding optimal timing and patient selection. The use of 3-drug combinations or maintenance chemotherapy is not supported.
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