Optimal sequencing in the treatment of recurrent ovarian cancer Journal Article
| Author: | Spriggs, D. |
| Article Title: | Optimal sequencing in the treatment of recurrent ovarian cancer |
| Abstract: | Improvements in ovarian cancer management mean that it may now be a long-term disease for which treatment must be carefully considered. Optimal sequencing of chemotherapy may help to enhance patients' benefit of therapy and minimize toxicity. The response to retreatment with platinum or a platinum/taxane combination is strongly influenced by the treatment-free interval after initial therapy with a platinum combination. Response rates to platinum retreatment in platinum-resistant patients (relapse within 6 months) are lower than those in platinum-sensitive patients (relapse after 6 months). Increasing the platinum-free interval by using non-platinum-based chemotherapy for treatment after relapse appears to increase the likelihood of response to later rechallenge with platinum. Many alternative agents have been investigated for the treatment of patients with relapsed ovarian cancer, including single-agent topotecan, which has been shown to achieve favorable responses. Topotecan may cause myelosuppression, which is noncumulative but tends to increase in direct correlation with the number of prior chemotherapy courses. Therefore, the best use of topotecan may be early in the course of salvage therapy. The hematologic toxicities associated with topotecan can also be reduced by adjusting the dose and schedule. Prolonged use of topotecan may be feasible and potentially beneficial in some patients. © 2003 Elsevier Inc. All rights reserved. |
| Keywords: | cancer survival; leukemia; cancer surgery; treatment failure; clinical trial; neutropenia; cancer recurrence; salvage therapy; cisplatin; doxorubicin; cancer combination chemotherapy; drug efficacy; side effect; conference paper; gemcitabine; paclitaxel; topotecan; nuclear magnetic resonance imaging; positron emission tomography; recurrent cancer; laparotomy; ovarian cancer; ovarian neoplasms; carboplatin; protein bcl 2; quality of life; computer assisted tomography; ovary cancer; bone marrow suppression; etoposide; blood toxicity; thrombocytopenia; antineoplastic combined chemotherapy protocols; peripheral neuropathy; patient monitoring; drug effect; diagnostic imaging; protein p53; cancer resistance; antigen detection; echography; drug response; platinum; physical examination; ca 125 antigen; taxane derivative; cancer control; hand foot syndrome; second look surgery; organoplatinum compounds; granulocyte colony stimulating factor; bone marrow toxicity; drug indication; sequencing; glycoprotein p; short course therapy; long term exposure; humans; prognosis; human; female; priority journal; chronotherapy; treatment-free interval; chronosequence |
| Journal Title: | Gynecologic Oncology |
| Volume: | 90 |
| Issue: | 3 Suppl. |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2003-09-01 |
| Start Page: | S39 |
| End Page: | S44 |
| Language: | English |
| DOI: | 10.1016/s0090-8258(03)00471-2 |
| PUBMED: | 13129495 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 25 September 2014 -- Source: Scopus |
