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Chapter 41 - Treatment of Epithelial Ovarian Cancers, Fallopian Tube Cancers and Peritoneal Surface Cancers

from Section 9 - Ovary and Fallopian Tubes

Published online by Cambridge University Press:  24 November 2021

By
Céline Montavon Sartorius  and
Viola Heinzelmann-Schwarz
Edited by
Tahir Mahmood ,
Charles Savona-Ventura ,
Ioannis Messinis  and
Sambit Mukhopadhyay
Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona-Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
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Summary

Epithelial ovarian cancer is currently still treated with chemotherapy using carboplatin and paclitaxel in a 3-weekly regimen. Maintenance treatment is started, using targeted therapy with anti-VEGF bevacizumab or PARP inhibitor olaparib. In the recurrent setting the classical platinum-resistant or -sensitive cut-off has loosened and these days time to next subsequent treatment is increasingly used. New drugs are being investigated in ovarian cancer, mainly CDK4/5 inhibitors and checkpoint inhibitors.

Keywords

cancerepithelialfallopianperitonealtreatmentsurgerychemotherapy
Type
Chapter
Information
The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
Gynaecology
 , pp. 357 - 365
Publisher: Cambridge University Press
Print publication year: 2021

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References

Colombo, N, Sessa, C, du Bois, A, et al. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent diseasedagger. Ann Oncol 2019;30:672–705.Google Scholar
Wilson, MK, Pujade-Lauraine, E, Aoki, D, et al. Fifth Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup: recurrent disease. Ann Oncol 2017;28:727–732.Google Scholar
Alsop, K, Fereday, S, Meldrum, C, et al. BRCA mutation frequency and patterns of treatment response in BRCA mutation-positive women with ovarian cancer: a report from the Australian Ovarian Cancer Study Group. J Clin Oncol 2012;30:2654–2663.Google Scholar
Vergote, I, De Brabanter, J, Fyles, A, et al. Prognostic importance of degree of differentiation and cyst rupture in stage I invasive epithelial ovarian carcinoma. Lancet 2001;357:176–182.CrossRefGoogle ScholarPubMed
Timmers, PJ, Zwinderman, AH, Coens, C, Vergote, I, Trimbos, JB. Understanding the problem of inadequately staging early ovarian cancer. Eur J Cancer 2010;46:880–884.Google Scholar
Harter, P, Sehouli, J, Lorusso, D, et al. LION: Lymphadenectomy in Ovarian Neoplasms – a prospective randomized AGO study group led gynecologic cancer intergroup trial. J Clin Oncol 2017;35(Suppl. 15):5500.Google Scholar
Bristow, RE, Tomacruz, RS, Armstrong, DK, Trimble, EL, Montz, FJ. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 2002;20:1248–1259.Google Scholar
du Bois, A, Reuss, A, Pujade-Lauraine, E, et al. Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe d’Investigateurs Nationaux Pour les Etudes des Cancers de l’Ovaire (GINECO). Cancer 2009;115:1234–1244.Google Scholar
Harter, P, du Bois, A, Hahmann, M, et al. Surgery in recurrent ovarian cancer: the Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) DESKTOP OVAR trial. Ann Surg Oncol 2006;13:1702–1710.Google Scholar
Bois, AD, Vergote, I, Ferron, G, et al. Randomized controlled phase III study evaluating the impact of secondary cytoreductive surgery in recurrent ovarian cancer: AGO DESKTOP III/ENGOT ov20. J Clin Oncol 2017;35(Suppl. 15):5501.Google Scholar
Du Bois A, Sehouli J, Vergote I, et al. Randomized phase III study to evaluate the impact of secondary cytoreductive surgery in recurrent ovarian cancer: Final analysis of AGO DESKTOP III/ENGOT-ov20. J Clin Oncol. DOI: 10.1200/JCO.2020.38.15_suppl.6000CrossRefGoogle Scholar
Vergote, I, Trope, CG, Amant, F, et al. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med 2010;363:943–953.Google Scholar
Kehoe, S, Hook, J, Nankivell, M, et al. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet 2015;386:249–257.Google Scholar
Parmar, MK, Ledermann, JA, Colombo, N, et al. Paclitaxel plus platinum-based chemotherapy versus conventional platinum-based chemotherapy in women with relapsed ovarian cancer: the ICON4/AGO-OVAR-2.2 trial. Lancet 2003;361:2099–2106.Google Scholar
Pignata, S, Scambia, G, Ferrandina, G, et al. Carboplatin plus paclitaxel versus carboplatin plus pegylated liposomal doxorubicin as first-line treatment for patients with ovarian cancer: the MITO-2 randomized phase III trial. J Clin Oncol 2011;29:3628–3635.CrossRefGoogle ScholarPubMed
Collinson, F, Qian, W, Fossati, R, et al. Optimal treatment of early-stage ovarian cancer. Ann Oncol 2014;25:1165–1171.Google Scholar
Wagner, U, Marth, C, Largillier, R, et al. Final overall survival results of phase III GCIG CALYPSO trial of pegylated liposomal doxorubicin and carboplatin vs paclitaxel and carboplatin in platinum-sensitive ovarian cancer patients. Br J Cancer 2012;107:588–591.CrossRefGoogle ScholarPubMed
Aghajanian, C, Blank, SV, Goff, BA, et al. OCEANS: a randomized, double-blind, placebo-controlled phase III trial of chemotherapy with or without bevacizumab in patients with platinum-sensitive recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer. J Clin Oncol 2012;30:2039–2045.Google Scholar
Fisterer, J. Carboplatin/pegylated liposomal doxorubicin/bevacizumab (CD-BEV) vs. carboplatin/gemcitabine/bevacizumab (CG-BEV) in patients with recurrent ovarian cancer: a prospective randomized phase III ENGOT/GCIG-Intergroup study (AGO study group, AGO-Austria, ANZGOG, GINECO, SGCTG) (9330). Ann Oncol 2018;29(Suppl. 8):viii332–viii358.Google Scholar
Poveda, A, Vergote, I, Tjulandin, S, et al. Trabectedin plus pegylated liposomal doxorubicin in relapsed ovarian cancer: outcomes in the partially platinum-sensitive (platinum-free interval 6–12 months) subpopulation of OVA-301 phase III randomized trial. Ann Oncol 2011;22:39–48.CrossRefGoogle ScholarPubMed
Katsumata, N, Yasuda, M, Takahashi, F, et al. Dose-dense paclitaxel once a week in combination with carboplatin every 3 weeks for advanced ovarian cancer: a phase 3, open-label, randomised controlled trial. Lancet 2009;374:1331–1338.Google Scholar
Clamp, AR. ICON8: a GCIG phase III randomised trial evaluating weekly dose-dense chemotherapy integration in first-line epithelial ovarian/fallopian tube/primary peritoneal carcinoma (EOC) treatment – results of primary progression-free survival (PFS) analysis. Ann Oncol 2017;28(Suppl. 5). doi:10.1093/annonc/mdx440.Google Scholar
Chan, JK, Brady, MF, Penson, RT, et al. Weekly vs. every-3-week paclitaxel and carboplatin for ovarian cancer. N Engl J Med 2016;374:738–748.Google Scholar
Pignata, S, Scambia, G, Katsaros, D, et al. Carboplatin plus paclitaxel once a week versus every 3 weeks in patients with advanced ovarian cancer (MITO-7): a randomised, multicentre, open-label, phase 3 trial. Lancet Oncol 2014;15:396–405.Google Scholar
Pujade-Lauraine, E, Hilpert, F, Weber, B, et al. Bevacizumab combined with chemotherapy for platinum-resistant recurrent ovarian cancer: the AURELIA open-label randomized phase III trial. J Clin Oncol 2014;32:1302–1308.Google Scholar
Jaaback, K, Johnson, N, Lawrie, TA. Intraperitoneal chemotherapy for the initial management of primary epithelial ovarian cancer. Cochrane Database Syst Rev 2016;1:CD005340.Google Scholar
van Driel, WJ, Koole, SN, Sikorska, K, et al. Hyperthermic intraperitoneal chemotherapy in ovarian cancer. N Engl J Med 2018;378:230–240.Google Scholar
Perren, TJ, Swart, AM, Pfisterer, J, et al. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med 2011;365:2484–2496.Google Scholar
Burger, RA, Brady, MF, Bookman, MA, et al. Incorporation of bevacizumab in the primary treatment of ovarian cancer. N Engl J Med 2011;365:2473–2483.Google Scholar
Pignata, S. Chemotherapy plus or minus bevacizumab for platinum-sensitive ovarian cancer patients recurring after a bevacizumab containing first line treatment: the randomized phase 3 trial MITO16B-MaNGO OV2B-ENGOT OV17. J Clin Oncol 2018;36(Suppl.):5506.Google Scholar
Franzese, E, Centonze, S, Diana, A, et al. PARP inhibitors in ovarian cancer. Cancer Treat Rev 2019;73:1–9.Google Scholar
Moore, K, Colombo, N, Scambia, G, et al. Maintenance olaparib in patients with newly diagnosed advanced ovarian cancer. N Engl J Med 2018;379:2495–2505.CrossRefGoogle ScholarPubMed
Mirza, MR, Monk, BJ, Herrstedt, J, et al. Niraparib maintenance therapy in platinum-sensitive, recurrent ovarian cancer. N Engl J Med 2016;375:2154–2164.Google Scholar
Fruscio, R, de Haan, J, Van Calsteren, K, et al. Ovarian cancer in pregnancy. Best Pract Res Clin Obstet Gynaecol 2017;41:108–117.Google Scholar
Rustin, GJ, van der Burg, ME, Griffin, CL, et al. Early versus delayed treatment of relapsed ovarian cancer (MRC OV05/EORTC 55955): a randomised trial. Lancet 2010;376:1155–1163.CrossRefGoogle ScholarPubMed

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