Personalized approach to the ovarian cancer treatment

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Abstract

The aim of the review is to summarize the modern views on etiopathogenesis and treatment of ovarian cancer, as well as to search for ways for a more personalized approach to the management of patients with this oncological disease. Despite the limited number of patients participating in clinical trials of ovarian cancer, there are obvious results of gradual evolution in its diagnosis and treatment. Studies of etiopathogenesis led to a better understanding of the ovarian cancer genesis mechanisms, whereas evolution in treatment was marked by combination of secondary cytoreductive surgery with the most effective chemotherapeutic drugs and biological agents. The introduction of biomarkers, particularly CA125 (cancer antigen 125), in the diagnostic algorithm for both primary and recurrent ovarian cancer has opened up new horizons for the application of effective methods of treatment at the disease earliest stages. However, in the landmark study of G.J. Rustin et al. there was no a statistically significant difference in disease-free and overall survival among female patients with immediate treatment of recurrent ovarian cancer based only on elevated CA125 and female patients in whom chemotherapy was initiated after the clinical symptoms manifestation. Conducting clinical trials in small cohorts of patients with certain ovarian cancer histotype will help to select one or another effective combination of chemotherapy and/or biological agents administered not only intravenously, but also intraperitoneally, and thereby provide the personalized approach to the treatment of this disease.

About the authors

A R Savinova

Tatarstan Regional Clinical Cancer Center

Author for correspondence.
Email: aigulkazan@mail.ru

I G Gataullin

Tatarstan Regional Clinical Cancer Center; Kazan State Medical Academy

Email: aigulkazan@mail.ru

References

  1. Аксель Е.М. Статистика злокачественных новообразований женской половой сферы. Онкогинекология. 2012; (1): 18-23.
  2. Anderson G.L. Ovarian cancer biomarker screening: still too early to tell. Women’s Health. 2010; 6 (4): 487-490. http://dx.doi.org/10.2217/whe.10.33
  3. Armstrong D.K., Bundy B., Wenzel L. et al. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. New Engl. J. Med. 2006; 354: 34-43. http://dx.doi.org/10.1056/NEJMoa052985
  4. Bast R.C.Jr. Molecular approaches to personalizing management of ovarian cancer. Ann. Oncol. 2011; 22 (suppl. 8): viii5-viii15.
  5. Bast R.C.Jr. Commentary: CA125 and the detection of recurrent ovarian cancer: a reasonably accurate biomarker for a difficult disease. Cancer. 2010; 116: 2850-2853. http://dx.doi.org/10.1002/cncr.25203
  6. Berek J.S., Friedlander M.L., Bast R.C.Jr. Ovarian cancer. In: Holland-frei cancer medicine. Ed. Hong W.K., Bast R.C.Jr., Hait W. et al. 8th edition. Shelton. 2010; 1344-1375.
  7. Bhat R.A., Chia Y.N., Lim Y.K. et al. Survival impact of secondary cytoreductive surgery for recurrent ovarian cancer in an Asian population. Oman Med. J. 2015; 30 (5): 344-352. http://dx.doi.org/10.5001/omj.2015.70
  8. Bookman M., Brady M.F., McGuire W.P. et al. Evaluation of new platinum-based treatment regimens in advanced-stage ovarian cancer: a phase III trial of the Gynecologic Cancer InterGroup. J. Clin. Oncol. 2009; 27: 1419-1425. http://dx.doi.org/10.1200/JCO.2008.19.1684
  9. Brown P.O., Palmer C. The preclinical natural history of serous ovarian cancer: defining the target for early detection. PLOS Med. 2009; 6 (7): E10000114. http://dx.doi.org/10.1371/journal.pmed.1000114
  10. Callahan R., Hurvitz S. Human epidermal growth factor receptor-2-positive breast cancer: current management of early, advanced, and recurrent disease. Curr. Opinion Obstet. Gynecol. 2011; 23: 37-43. http://dx.doi.org/10.1097/GCO.0b013e3283414e87
  11. Clemente-Gutierrez U., Garza-Gangemi A., Trejo-Gomez G., Medina-Franco H. Morbidity and mortality following cytoreductive surgery with hyperthermic intraperitoneal chemotherapy at a tertiary clinical cancer center: initial experience. Rev. Invest. Clin. 2015; 67: 39-45.
  12. Coccolini F., Campanati L., Catena F. et al. Hyperthermic intraperitoneal chemotherapy with cisplatin and paclitaxel in advanced ovarian cancer: a multicenter prospective observational study study. J. Gynecol. Oncol. 2015; 26: 54-61. http://dx.doi.org/10.3802/jgo.2015.26.1.54
  13. Essaf M., Cooper K. Imatinib as adjuvant therapy for gastrointestinal stromal tumors: a systematic review. Int. J. Cancer. 2011; 128; 2202-2214. http://dx.doi.org/10.1002/ijc.25827
  14. Fleming N.D., Cass I., Walsh C.S. et al. CA125 surveillance increases optimal respectability at secondary cytoreductive surgery for recurrent epithelial ovarian cancer. Gynecol. Oncol. 2011; 121: 249-252. http://dx.doi.org/10.1016/j.ygyno.2011.01.014
  15. Helm C.W. Hyperthermic intraperitoneal chemotherapy for ovarian cancer: is there a role? J. Gynecol. Oncol. 2015; 1 (26): 1-2. http://dx.doi.org/10.3802/jgo.2015.26.1.1
  16. Jabbour E., Cortes J., Kantarjian H. Long-term outcomes in the second-line treatment of chronic myeloid leukemia: a review of tyrosine kinase inhibitors. Cancer. 2011; 117: 897-906. http://dx.doi.org/10.1002/cncr.25656
  17. Jacobs I.J., Kohler M.F., Wiseman R. et al. Clonal origin of epithelial ovarian carcinoma: analysis by loss of heterozygosity, p53 mutation and X chromosome inactivation. J. Natl. Cancer Inst. 1992; 84: 1793-1798. http://dx.doi.org/10.1093/jnci/84.23.1793
  18. Jemal A., Siegel R., Ward E. et al. Cancer statistics. CA Cancer J. Clin. 2009; 59: 225-249. http://dx.doi.org/10.3322/caac.20006
  19. Jemal A., Siegel R., Xu J. et al. Cancer statistics. CA Cancer J. Clin. 2010; 60: 277-300. http://dx.doi.org/10.3322/caac.20073
  20. Kurman R.J., Shih I.E.M. The origin and pathogenesis of epithelial ovarian cancer: a proposed unifying theory. Am. J. Surg. Pathol. 2010; 34: 433-443. http://dx.doi.org/10.1097/PAS.0b013e3181cf3d79
  21. Kwa M., Jandial D. Modulation of intraperitoneal (IP) chemotherapy in ovarian cancer. Transl. Cancer Res. 2014; 4: 60-69.
  22. Chiva L.M., Gonzalez-Martin A. A critical appraisal of hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of advanced and recurrent ovarian cancer. Gynecol. Oncol. 2015; 136: 130-135. http://dx.doi.org/10.1016/j.ygyno.2014.11.072
  23. Mehra K., Mehrad M., Ning G. et al. STICS, SCOUTs and p53 signatures; a new language for pelvic serous carcinogenesis. Front. Biosci. 2011; 3: 625-634.
  24. Mok T.S., Zhou Q., Leung L. et al. Personalized medicine for non-small cell lung cancer. Expert Rev. Anticancer Ther. 2010; 10: 1601-1611. http://dx.doi.org/10.1586/era.10.76
  25. Oseledchyk A., Zivanovic O. Intraoperative hyperthermic intraperitoneal chemotherapy in patients with advanced ovarian cancer. Oncology (Williston Park). 2015; 29: 695-701.
  26. Padmanabhan N., Kumar B.R., Pookunju A.P. et al. Analysis if Cytoreductive surgery with hyperhtermic intraperitoneal chemotherapy (CRS/HIPEC) from a tertiary cancer center in India. J. Clin. Diagn. Res. 2015; 9 (6): XC09-XC13.
  27. Parmar M.K., Ledermann J.A., 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. http://dx.doi.org/10.1016/S0140-6736(03)13718-X
  28. Poskus E., Strupas K., Guschin V., Sugarbaker P.H. Cytoreductive surgery and HIPEC in the Baltic States: an International Scientific Workshop with live surgery. Viszeralmedizin. 2014; 30: 353-359. http://dx.doi.org/10.1159/000368685
  29. Rustin G.J., van der Burg M.E., Griffin C.L. et al. MRC OV05/EORTC 55955 investigators. Early versus delayed treatment of relapsed ovarian cancer (MRC OV05/EORTC 55955): a randomised trial. Lancet. 2010; 376: 1155-1163. http://dx.doi.org/10.1016/S0140-6736(10)61268-8
  30. Santillan A., Garg R., Zahurak M.L. et al. Risk of epithelial ovarian cancer recurrence in patients with rising serum CA-125 levels within the normal range. J. Clin. Oncol. 2005; 23: 9338-9343. http://dx.doi.org/10.1200/JCO.2005.02.2582
  31. Shen Y.A., Shyu I.L., Lu M. et al. Bypassing the EPR effect with nanomedicine harboring a sustained - release function allows better tumor control. Intern. J. Nanomedicine. 2015; 10: 2485-2502.
  32. Sullivan M.G. CA125 plus ultrasound detects early ovarian Ca. Women’s Health. 2009;1: 27.
  33. Tewari D., Java J.J., Salani R. et al. Long-term survival advantage and prognostic factors associated with intraperitoneal chemotherapy treatment in advanced ovarian cancer: a Gynecologic Oncology Group Study. J. Clin. Oncol. 2015; 33: 1460-1466. http://dx.doi.org/10.1200/JCO.2014.55.9898
  34. Tsinmberidou A.M. Personalized medicine in a phase I trials program: the M.D. Anderson initiative. J. Clin. Oncol. 2011; 29 (18S): 787s.
  35. Wei P., Zhang W., Li X. et al. Evaluation of prognostic factors for secondary cytoreductive surgery in Chinese patients with recurrent epithelial ovarian carcinoma. Int. J. Clin. Exp. Med. 2015; 8 (1): 1066-1072.

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