LH-RH Agonists in the Treatment of Ovarian Cancer

Ovarian carcinoma is one of the most common causes of cancer death in women. During the last decade there have been some advances in surgical, radiation, and cytotoxic chemotherapy of this malignancy. The overall results of these treatments, however, are still disappointing (MRC Gynecologic Cancer Working Party 1990; Averette and Donato 1990; Blackledge and Lawton 1989). Aggressive chemotherapy is burdened with severe acute side effects. In addition, chemotherapy in ovarian cancer is associated with a 4–12 times higher risk of developing leukemia (Kaldor et al. 1990). One trend in modern oncology has been to reduce at least therapy-induced morbidity, if the efficacy of therapy cannot be improved by increased aggressiveness. With breast and endometrial cancer this has been successfully achieved by the introduction of endocrine treatments, both ablative or additive, that take advantage of the sex-steroid dependence of some of these tumors, as reflected by the presence of estrogen and/or progestin receptors (Desombre et al. 1987). Also many ovarian cancers contain significant amounts of sex-steroid receptors. Therapeutic approaches, however, using either antiestrogens or progestins, have not been satisfying (for review, see Desombre et al. 1987; Rao and Slotman 1991).