Frontline Management of Epithelial Ovarian Cancer—Combining Clinical Expertise with Community Practice Collaboration and Cutting-Edge Research
Abstract
:1. Introduction
2. Surgical Management
3. Gynecologic Pathology: Diagnostic Evaluation
4. Molecular Studies Available for Diagnostic or Therapeutic Decision Support and Emerging Translational Research
5. Adjuvant Chemotherapy
6. Maintenance Therapy
7. Genetic Counseling
8. Team Medicine: Optimizing Partnerships and Clinical Research
9. Summary
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Study | Patients | Experimental | Control | Progression Free Survival | Overall Survival |
---|---|---|---|---|---|
JGOG 3016 [52,56] | Stage II-IV EOC | three-weekly carboplatin (AUC 6) and weekly paclitaxel (80 mg/m2) for six cycles | three-weekly carboplatin (AUC 6) and paclitaxel (180 mg/m2) for six cycles | 28.0 vs. 17.2 months; HR 0.71, 95% CI 0.58–0.88; p = 0.0015 | 100.5 vs. 62.2 months (HR 0.79, 95% CI 0.63–0.99; p = 0.039 |
MITO-7 [54] | FIGO stage IC-IV EOC | Weekly carboplatin (AUC 2) and paclitaxel (60 mg/m2) for 18 weeks | three-weekly carboplatin (AUC 6) and paclitaxel (175 mg/m2) for six cycles | 18.3 vs. 17.3 months; HR 0·96, 95% CI 0·80–1.16; p = 0·66 | - |
ICON-8 [55] | FIGO stage IC-IV EOC | Group 2: three-weekly carboplatin (AUC 5/6) and weekly paclitaxel (80 mg/m2) for six cycles Group 3: Weekly carboplatin (AUC 6) and paclitaxel (60 mg/m2) for 18 weeks | Group 1: three-weekly carboplatin (AUC 5/6) and paclitaxel (175 mg/m2) for six cycles | Group 1 vs. Group 2 vs. Group 3: 17.7 vs. 20.8 vs. 21.0 Group 2 vs. Group 1: p = 0.35 Group 3 vs. Group 1: p = 0.51 | - |
GOG-172 [27,65] | FIGO stage III with optimal debulking | paclitaxel 135 mg/m2 continuous iv infusion over 24 h on day 1, cisplatin 100 mg/m2 IP on day 2, paclitaxel 60 mg/m2 IP on day 8 for six cycles | paclitaxel 135 mg/m2 continuous IV infusion over 24 h on day 1, cisplatin 75 mg/m2 IV on day 2 for six cycles | 23.8 vs. 18.3 months; HR 0.80, 95% CI 0.64–1.00; p = 0.05 | 65.6 vs. 49.7 months; HR 0.75, 95% CI, 0.58–0.97; p = 0.03 61.8 vs. 51.4 months; Adjusted HR 0.77; 95% CI, 0.65–0.90; p = 0.002 |
GOG-252 [28] | FIGO stage II-IV EOC | paclitaxel 80 mg/m2 IV on days 1, 8, and 15 plus carboplatin AUC 6 IP on day 1 every 21 days for cycles 1–6 plus bevacizumab 15 mg/kg IV every 21 days for cycles 2–22 paclitaxel 135 mg/m2 IV on day 1 plus cisplatin 75 mg/m2 IP on day 2 plus paclitaxel 60 mg/m2 IV on day 8 every 21 days for cycles 1–6 plus bevacizumab 15 mg/kg IV every 21 days for cycles 2–22 | paclitaxel 80 mg/m2 IV on days 1, 8, and 15 plus carboplatin AUC 6 IV on day 1 every 21 days for cycles 1–6 plus bevacizumab 15 mg/kg IV every 21 days for cycles 2–22 | IV vs. IP-carboplatin vs. IP-cisplatin: 24.9 vs. 27.4 vs. 26.2 months IP-carboplatin: HR 0.93, 95% CI 0.80–1.07 IP-cisplatin: HR 0.98, 95% CI 0.84–1.13 | IV vs. IP-carboplatin vs. IP-cisplatin: 75.5 vs. 78.9 vs. 72.9 months IP-carboplatin: HR 0.95, 95% CI 0.80–1.13 IP-cisplatin: HR 1.05, 95% CI; 0.88–1.24; |
GOG-262 [53] | FIGO stage III-IV EOC | three-weekly carboplatin (AUC 6) and weekly paclitaxel (80 mg/m2), plus/minus three-weekly bevacizumab 15 mg/kg for six cycles | three-weekly carboplatin (AUC 6) and paclitaxel (175 mg/m2), plus/minus three-weekly bevacizumab 15 mg/kg for six cycles | With bevacizumab: 14.9 vs. 14.7 months; HR 0.99, 95% CI 0.83–1.20; p = 0.60 Without bevacizumab: 14.2 vs. 10.3 months; HR 0.62, 95% CI 0.40–0.95; p = 0.03 | With and without bevacizumab: 40.2 vs. 39.0 months; HR 0.94; 95% CI, 0.72–1.2 |
SOLO-1 [67] | FIGO stage III or IV high-grade serous or endometrioid EOC patients with a deleterious or suspected deleterious germline or somatic BRCA1/2 mutation, completed frontline platinum-based chemotherapy | olaparib | placebo | Not reached vs. 13.8 months; HR 0.30, 95% CI 0.23–0.41); p < 0.0001 3-year: 60% vs. 27%; 4-year: 53% vs. 11% | - |
PAOLA-1 [68] | FIGO stage III or IV high-grade EOC patients after first-line treatment with platinum–taxane chemotherapy plus bevacizumab | olaparib plus bevacizumab | placebo plus bevacizumab | 22.1 vs. 16.6 months; HR 0.59; 95% CI 0.49–0.72; p < 0.001 HRD plus BRCA mutation: 37.2 vs. 17.7 months; HR 0.33, 95% CI 0.25–0.45 HRD minus BRCA mutation: 28.1 vs. 16.6 months; HR 0.43, 95% CI 0.28–0.66 | - |
PRIMA [69] | FIGO stage III or IV high-grade serous or endometrioid EOC patients after first-line treatment with platinum-based chemotherapy | niraparib | placebo | Overall: 13.8 vs. 8.2 months; HR .62, 95% CI 0.50–0.76; p < 0.001 HRD-positive: 21.9 vs. 10.4 months; HR 0.43, 95% CI 0.31–0.59; p < 0.001 | - |
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Wang, E.W.; Wei, C.H.; Liu, S.; Lee, S.J.-J.; Shehayeb, S.; Glaser, S.; Li, R.; Saadat, S.; Shen, J.; Dellinger, T.; et al. Frontline Management of Epithelial Ovarian Cancer—Combining Clinical Expertise with Community Practice Collaboration and Cutting-Edge Research. J. Clin. Med. 2020, 9, 2830. https://doi.org/10.3390/jcm9092830
Wang EW, Wei CH, Liu S, Lee SJ-J, Shehayeb S, Glaser S, Li R, Saadat S, Shen J, Dellinger T, et al. Frontline Management of Epithelial Ovarian Cancer—Combining Clinical Expertise with Community Practice Collaboration and Cutting-Edge Research. Journal of Clinical Medicine. 2020; 9(9):2830. https://doi.org/10.3390/jcm9092830
Chicago/Turabian StyleWang, Edward Wenge, Christina Hsiao Wei, Sariah Liu, Stephen Jae-Jin Lee, Susan Shehayeb, Scott Glaser, Richard Li, Siamak Saadat, James Shen, Thanh Dellinger, and et al. 2020. "Frontline Management of Epithelial Ovarian Cancer—Combining Clinical Expertise with Community Practice Collaboration and Cutting-Edge Research" Journal of Clinical Medicine 9, no. 9: 2830. https://doi.org/10.3390/jcm9092830