Frontline therapy of ovarian cancer: trials and tribulations

Curr Opin Obstet Gynecol. 2018 Feb;30(1):1-6. doi: 10.1097/GCO.0000000000000434.

Abstract

Purpose of review: The current article reviews the advances and challenges in the fight with cancer and the hope for cure, with a focus on clinical trials, at the one time with the best outcomes; first-line therapy.

Recent findings: To date there have been four great stories that bridge inception to development of new drugs in ovarian cancer: Serendipitous insight into the role of platinum, discovery of taxanes, understanding the microenvironment and angiogenesis, and following the science in the development of Poly (ADP-Ribose) Polymerase (PARP) inhibitors. There is a fundamental difference between overall survival (OS), simply living longer; and eradicating disease, cure. The scientific underpinning of both our understanding and the recent developments encourages an optimistic view of the remaining hurdles.

Summary: There has been an unprecedented explosion in the number of new drugs approved for the treatment of ovarian cancer with three new classes of agent, and five new drugs receiving food and drug administration approval in the last 3 years (Fig. 2). Getting the right drug truly transforms patients' experience with the seminal event being the development of imatinib in CML. In 1980, an average patient would have lived only 3 years, and now they only live 3 years less than a full lifespan [Bower et al. (2016). J Clin Oncol 34:2851].

Publication types

  • Historical Article
  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / history
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Antineoplastic Protocols
  • Biomedical Research / history*
  • Biomedical Research / methods
  • Biomedical Research / trends
  • Combined Modality Therapy / adverse effects
  • Combined Modality Therapy / history
  • Drug Approval / history
  • Evidence-Based Medicine*
  • Female
  • History, 18th Century
  • History, 19th Century
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Immunotherapy, Adoptive / adverse effects
  • Immunotherapy, Adoptive / history
  • Molecular Targeted Therapy / adverse effects
  • Molecular Targeted Therapy / history
  • Ovarian Neoplasms / drug therapy
  • Ovarian Neoplasms / history
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / therapy*
  • Survival Rate
  • United States / epidemiology
  • United States Food and Drug Administration