Antineoplastic agents in the management of ovarian cancer: current status and emerging therapeutic strategies

• Published in: Trends in pharmacological sciences (Regular ed.) 2008-10, Vol.29 (10), p.515-519
• Main Author: Markman, Maurie
• Format: Article
• Language: English
• Subjects: Advanced Basic Science; Antineoplastic Agents - adverse effects; Antineoplastic Agents - pharmacology; Clinical Trials, Phase III as Topic; Drug Delivery Systems; Drug Resistance, Neoplasm; Female; Humans; Neoplasm Recurrence, Local - drug therapy; Neovascularization, Pathologic - drug therapy; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - physiopathology
• ISSN: 0165-6147; 1873-3735
• DOI: 10.1016/j.tips.2008.07.007

The intent of this review is to critically examine the status of the current chemotherapeutic management of ovarian cancer and possible future directions. Standard systemic chemotherapy includes a platinum agent (cisplatin or carboplatin) and a taxane (paclitaxel or docetaxel), a strategy that has not changed in more than a decade. Phase-III-trial data have revealed the superior efficacy of intraperitoneal cisplatin, compared with systemic platinum delivery, in small-volume residual advanced ovarian cancer, but in general this approach is associated with greater toxicity. Several regimens have been shown to be active in recurrent and platinum-resistant ovarian cancer, but an optimal management strategy has not been defined. Although ‘targeted therapeutic approaches’ are currently being explored in this disease, with the important exception of anti-angiogeneic agents, to date, limited biological and clinical activity have been demonstrated.