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Traitement médical de première ligne du cancer épithélial de l'ovaire de haut grade: First-line medical treatment of high-grade epithelial ovarian cancer.
- Source :
-
Bulletin du cancer [Bull Cancer] 2021 Dec; Vol. 108 (9S1), pp. S5-S12. - Publication Year :
- 2021
-
Abstract
- In early stages, standard treatment is adjuvant chemotherapy, consisting of platinum-based combination for 6 cycles, especially in serous and endometrioid high grade carcinomas. In advanced stages, indication of neoadjuvant chemotherapy must be discussed on a case-by-case basis in multidisciplinary meetings (MDM). Bevacizumab can also be considered in the neoadjuvant setting in some circumstances, always after discussion in MDM. Carboplatin plus paclitaxel every 21 days, with or without bevacizumab remains the standard of care for first-line chemotherapy. Inhibitors of poly-(ADP-riboses) polymerases (PARPi) have been approved and are reimbursed as maintenance monotherapy in tumors carrying BRCA1 or BRCA2 mutation after complete or partial response to chemotherapy. Two recent studies demonstrated the efficacy of PARPi on progression free survival, one for niraparib single-agent in patients with high-grade ovarian carcinoma regardless of BRCA status, the other one for the combination of bevacizumab and olaparib in patients with high grade carcinoma, with positive test for homologous recombination DNA repair deficiency (regardless of BRCA status). These two new modalities of maintenance therapy are now available in compassionate use programs or post compassionate use programs. Depending on pending decisions upon reimbursement, these indications might be somewhat modified.<br /> (Copyright © 2021 Société FranÇaise du Cancer. Publié par Elsevier Masson SAS. Tous droits réservés.)
- Subjects :
- Algorithms
Bevacizumab therapeutic use
Carboplatin therapeutic use
Carcinoma, Ovarian Epithelial genetics
Carcinoma, Ovarian Epithelial pathology
Chemotherapy, Adjuvant
Drug Administration Schedule
Female
Genes, BRCA1
Genes, BRCA2
Humans
Indazoles therapeutic use
Maintenance Chemotherapy
Neoadjuvant Therapy
Neoplasm Grading
Neoplasm Staging
Ovarian Neoplasms genetics
Ovarian Neoplasms pathology
Paclitaxel therapeutic use
Phthalazines therapeutic use
Piperazines therapeutic use
Piperidines therapeutic use
Poly(ADP-ribose) Polymerase Inhibitors therapeutic use
Antineoplastic Agents therapeutic use
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Carcinoma, Ovarian Epithelial drug therapy
Ovarian Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1769-6917
- Volume :
- 108
- Issue :
- 9S1
- Database :
- MEDLINE
- Journal :
- Bulletin du cancer
- Publication Type :
- Academic Journal
- Accession number :
- 34955161
- Full Text :
- https://doi.org/10.1016/S0007-4551(21)00582-8