Unfortunately, patients with ovarian cancer often have their disease recurred. As I discussed earlier, we divide the patients into platinum sensitive (have not seen carboplatin or cisplatin in the last 6 months) or platinum resistant (resistant to carbo or cisplatin). The prognosis is better with platinum sensitive disease. The treatment usually consists of doublet chemo (2 agents) rather than single agent based on ICON4 study. The most common combination would be carboplatin and paclitaxel (Taxol) since ICON4 study showed that this combination has survival advantage compared to other platinum based chemo. Other choices are carboplatin + Doxil or Carboplatin + Gemzar (please note that none of these have survival advantage in comparison to their control arm).
In platinum resistant, we don't use cisplatin or carboplatin. But paclitaxel, doxil, topotecan, oral etoposide (VP 16) are active. Recently, the West Clinic published a study using abraxane and avastin on patient with platinum resistant which showed about 50% response rate. To the best of my knowledge, this is the highest response rate ever documented in medical literature.
In platinum resistant, we don't use cisplatin or carboplatin. But paclitaxel, doxil, topotecan, oral etoposide (VP 16) are active. Recently, the West Clinic published a study using abraxane and avastin on patient with platinum resistant which showed about 50% response rate. To the best of my knowledge, this is the highest response rate ever documented in medical literature.
Phase
II clinical trial of bevacizumab with albumin-bound paclitaxel in
patients with recurrent, platinum-resistant primary epithelial ovarian
or primary peritoneal carcinoma.
Tillmanns TD, Lowe MP, Walker MS, Stepanski EJ, Schwartzberg LS.
Gynecol Oncol. 2013
No comments:
Post a Comment