Evolving concepts in the management of drug resistant ovarian cancer: dose dense chemotherapy and the reversal of clinical platinum resistance.

Abstract:

:Despite the initially high response rate to standard front-line debulking surgery followed by platinum-based chemotherapy, the relapse rate in ovarian cancer is high and many patients will recur within 6 months of completing platinum based treatment. These patients may still require further chemotherapy despite being considered "platinum resistant". In this setting, response rates to conventionally scheduled second line platinum and non-platinum agents is low, ranging between 5% and 15%. There is an emerging body of evidence that in this scenario, chemotherapeutic activity can be enhanced using unconventionally scheduled "dose-dense" platinum and non-platinum based regimens with improved response rates of up to 65%. Randomised studies to evaluate the impact of this approach on survival in recurrent, platinum resistant disease are urgently required to confirm the promising phase II findings if there is to be a change in the standard of care of patients with platinum resistant disease. In this review we discuss the evolving strategies to overcome resistance in patients with platinum resistant ovarian cancer with a particular focus on alterations in dose schedule as a means of reversing platinum resistance.

journal_name

Cancer Treat Rev

journal_title

Cancer treatment reviews

authors

Pinato DJ,Graham J,Gabra H,Sharma R

doi

10.1016/j.ctrv.2012.04.004

subject

Has Abstract

pub_date

2013-04-01 00:00:00

pages

153-60

issue

2

eissn

0305-7372

issn

1532-1967

pii

S0305-7372(12)00081-3

journal_volume

39

pub_type

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