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Where do Antiangiogenic Agents Belong in the Treatment Algorithm for Ovarian Cancer?

Dizon, Don S. MD, FACP

American Journal of Clinical Oncology: October 2013 - Volume 36 - Issue 5 - p 519–525
doi: 10.1097/COC.0b013e318216e699
Review Articles

Although epithelial ovarian cancer responds well to chemotherapy, patients presenting with advanced disease still have a poor prognosis. The clear role of angiogenesis in the development and progression of ovarian tumorigenesis has led to the development of several novel antiangiogenic agents; however, questions remain as how to best incorporate such agents into current treatment algorithms. Searches of PubMed (terms: angiogenesis, VEGF, tyrosine kinase inhibitor, bevacizumab and ovarian cancer) and of recent results from key oncology congresses (terms: drug names and ovarian cancer) were performed to identify relevant articles and abstracts. Clinical trials are ongoing to evaluate investigational antiangiogenic agents as a component of first-line chemotherapy, as a treatment option for recurrent disease, and as maintenance therapy for ovarian cancer. The antiangiogenic monoclonal antibody bevacizumab has demonstrated a progression-free survival benefit in combination with first-line paclitaxel/carboplatin and continued as maintenance therapy, and phase II data suggest therapeutic potential for several multitargeted tyrosine kinase inhibitors in ovarian cancer, with phase III results forthcoming for BIBF 1120, cediranib, and pazopanib. Antiangiogenic therapy remains a promising strategy for ovarian cancer, and it is hoped that results from ongoing trials will inform their optimal placement in the treatment paradigm.

Department of Obstetrics & Gynecology and Medicine, Warren Alpert Medical School of Brown University and Women & Infants’ Hospital of Rhode Island, Providence, RI

Funding: Supported by Boehringer Ingelheim Pharmaceuticals, Inc (BIPI). The author received no compensation related to the development of the manuscript.

Writing and editorial assistance was provided by Alyssa Tippens, PhD, of MedErgy, which was contracted by BIPI for these services. The author meets the criteria for authorship as recommended by the International Committee of Medical Journal Editors (ICMJE), was fully responsible for all content and editorial decisions, and was involved at all stages of manuscript development.

Reprints: Don S. Dizon, MD, FACP, The Warren Alpert Medical School of Brown University, Medical Oncology and Integrative Care, The Center for Sexuality, Intimacy, and Fertility, The Program in Women's Oncology, Women & Infants' Hospital of Rhode Island, 101 Dudley Street, Providence, RI 02905. e-mail: DDizon@WIHRI.org.

© 2013 by Lippincott Williams & Wilkins, Inc