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First-line Chemotherapy in Epithelial Ovarian Cancer

BOOKMAN, MICHAEL A. MD

Clinical Obstetrics & Gynecology: March 2012 - Volume 55 - Issue 1 - p 96–113
doi: 10.1097/GRF.0b013e31824b45da
Ovarian Cancer

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 antiangiogenic agents, but with questions regarding optimal timing and patient selection. The use of 3-drug combinations or maintenance chemotherapy is not supported.

University of Arizona Cancer Center, Tucson, Arizona

The author declares that he has nothing to disclose.

Correspondence: Michael A. Bookman, MD, University of Arizona Cancer Center, 1515 N. Campbell Ave., Tucson, AZ. E-mail: mbookman@azcc.arizona.edu

© 2012 Lippincott Williams & Wilkins, Inc.