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First-Line and Maintenance Therapy for Ovarian Cancer: Current Status and Future Directions

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Abstract

Paclitaxel and carboplatin combination chemotherapy has remained the standard of care in the frontline therapy of advanced epithelial ovarian carcinoma during the last decade. Maintenance chemotherapy or immunotherapy has not been proven to impact on overall survival and only one clinical trial that explored the administration of monthly paclitaxel for 1 year showed a benefit in terms of progression-free survival (PFS), but at the cost of maintained alopecia and increased peripheral neuropathy. This scenario may be changing with the incorporation of targeted therapy to the frontline therapy of ovarian cancer. In particular, anti-angiogenic therapy has been identified as the most promising targeted therapy, and the addition of bevacizumab to first-line chemotherapy followed by a maintenance period of bevacizumab in monotherapy has shown to prolong PFS. This was considered the proof of concept of the value of anti-angiogenic therapy in the frontline of ovarian cancer, and the results of two additional clinical trials with anti-angiogenic tyrosine-kinase inhibitors have shown results in the same direction.

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Author’s Disclosures of Potential Conflict of Interest

Dr. González-Martín has received a grant as advisor and speaker for Roche and Amgen. Drs. Sánchez-Lorenzo, Bratos, Márquez and Chiva have no conflicts of interest to declare.

No sources of funding were used in the preparation of this paper.

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Authors and Affiliations

  1. Medical Oncology Department, MD Anderson Cancer Center, C/Arturo Soria 270, 28033, Madrid, Spain

    Antonio González-Martín, Raquel Bratos & Raúl Márquez

  2. Medical Oncology Service, Hospital Central de Asturias, C/Celestino Villamil s/n, 33006, Oviedo, Spain

    Luisa Sánchez-Lorenzo

  3. Gynecologic Oncology Department, MD Anderson Cancer Center, Madrid, Spain

    Luis Chiva

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  1. Antonio González-Martín
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Correspondence to Antonio González-Martín.

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González-Martín, A., Sánchez-Lorenzo, L., Bratos, R. et al. First-Line and Maintenance Therapy for Ovarian Cancer: Current Status and Future Directions. Drugs 74, 879–889 (2014). https://doi.org/10.1007/s40265-014-0221-9

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