The systemic treatment of recurrent ovarian cancer revisited

T Baert; A Ferrero; J Sehouli; D M O'Donnell; A González-Martín; F Joly; J van der Velden; P Blecharz; D S P Tan; D Querleu; N Colombo; A du Bois; J A Ledermann

doi:10.1016/j.annonc.2021.02.015

The systemic treatment of recurrent ovarian cancer revisited

Ann Oncol. 2021 Jun;32(6):710-725. doi: 10.1016/j.annonc.2021.02.015. Epub 2021 Mar 3.

Authors

T Baert¹, A Ferrero², J Sehouli³, D M O'Donnell⁴, A González-Martín⁵, F Joly⁶, J van der Velden⁷, P Blecharz⁸, D S P Tan⁹, D Querleu¹⁰, N Colombo¹¹, A du Bois¹², J A Ledermann¹³

Affiliations

¹ Department of Gynecology and Gynecological Oncology, Kliniken Essen-Mitte, Essen, Germany; Department of Oncology, KU Leuven, Leuven, Belgium. Electronic address: thais.baert@gmail.com.
² Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, Mauriziano Hospital, Turin, Italy.
³ Department of Gynecology with Center for Oncological Surgery, Charité-University hospital Berlin, Berlin, Germany.
⁴ Department of Oncology, St. James's Hospital, Dublin, Ireland.
⁵ Medical Oncology Department, Clínica Universidad de Navarra University Hospital, Madrid, Spain.
⁶ Department of Oncology, Centre Francois Baclesse, Caen, France.
⁷ Department of Medical Oncology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
⁸ Department of Gynecologic Oncology, Center of Oncology, M. Sklodowska-Curie Institute, Krakow, Poland.
⁹ Department of Haematology-Oncology, National University Cancer Institute of Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
¹⁰ Department of Surgical Oncology, Institut Bergonié, Bordeaux, France.
¹¹ Department of Medicine and Surgery, European Institute of Oncology IRCCS, Milan, Italy; University of Milan-Bicocca, Milan, Italy.
¹² Department of Gynecology and Gynecological Oncology, Kliniken Essen-Mitte, Essen, Germany.
¹³ Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, London, UK.

PMID: 33675937
DOI: 10.1016/j.annonc.2021.02.015

Abstract

Treatment approaches for relapsed ovarian cancer have evolved over the past decade from a calendar-based decision tree to a patient-oriented biologically driven algorithm. Nowadays, platinum-based chemotherapy should be offered to all patients with a reasonable chance of responding to this therapy. The treatment-free interval for platinum is only one of many factors affecting patients' eligibility for platinum re-treatment. Bevacizumab increases the response to chemotherapy irrespective of the cytotoxic regimen and can be valuable in patients with an urgent need for symptom relief (e.g. pleural effusion, ascites). For patients with recurrent high-grade ovarian cancer, which responds to platinum-based treatment, maintenance therapy with a poly(ADP-ribose) polymerase inhibitor can be offered, regardless of the BRCA mutation status. Here we review contemporary decision-making processes in the systemic treatment of relapsed ovarian cancer.

Keywords: platinum re-treatment; platinum-based chemotherapy; poly(ADP-ribose) polymerase (PARP) inhibitor; recurrent ovarian cancer.

Publication types

Review

MeSH terms

Antineoplastic Agents* / therapeutic use
Carcinoma, Ovarian Epithelial / drug therapy
Carcinoma, Ovarian Epithelial / genetics
Female
Humans
Neoplasm Recurrence, Local / drug therapy
Ovarian Neoplasms* / drug therapy
Ovarian Neoplasms* / genetics
Poly(ADP-ribose) Polymerase Inhibitors / therapeutic use

Substances

Antineoplastic Agents
Poly(ADP-ribose) Polymerase Inhibitors