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Management Strategies for Recurrent Platinum-Resistant Ovarian Cancer

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Abstract

Although ovarian cancer is often a chemosensitive malignancy, patients who are resistant to platinum-based chemotherapy represent a therapeutic challenge. Currently, the only drugs that are US FDA approved to treat this subset of patients are paclitaxel, pegylated liposomal doxorubicin (PLD) and topotecan. The response rates with these agents is in the 10–15% range and overall survival is around 12 months. Other drugs that have shown some activity in platinum-resistant ovarian cancer include the taxane analogues, oral etoposide, pemetrexed and bevacizumab. Unfortunately, randomized phase III trials of second-line chemotherapy in patients with platinum-resistant ovarian cancer have not shown an advantage over existing therapy with respect to progression-free survival or overall survival. The only trial that has reported a significant progression-free survival advantage over standard therapy is a randomized phase II trial of PLD with or without EC145, a folate-linked vinca alkaloid. Final survival results of this trial are pending.

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Acknowledgements

Dr Naumann has provided consulting services (without honorarium) to GlaxoSmithKline (GSK), Endocyte, OSI, Novartis, Abraxis, Merck and the GOG. He is involved in research that provides institutional support (without direct payment) sponsored by Amgen, Boehringer Ingelheim, Endocyte, OSI, Novartis, Morphotex and the GOG. He is the Principle Investigator for two phase II trials of EC145 (Endocyte).

In the last year, Professor Coleman has provided consulting, advisory board or speaking services to Abbott Laboratories, Allos Therapeutics, BiPar, Boehringer Ingelheim, Eli Lily, Endocyte, GSK, Sanofi-Aventis, Amgen, AstraZeneca, Centocor, Daiichi Sankyo, Genentech, Merck, Nektar and Ortho Biotech; and received research funding from Novartis, Abraxis, Sanofi-Aventis and Morphotek. None of the relationships listed has influenced the content of the article but are listed for full disclosure purposes. Professor Coleman is the Ann Rife Cox Professor in Gynecology; portions of this work were additionally supported by the Ovarian Cancer Research Fund Inc. (Program Project Development Grant) and the National Institutes of Health (P50 CA098258).

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  1. Carolinas Medical Center, 1025 Morehead Medical Drive, Charlotte, NC, 28204, USA

    R. Wendel Naumann

  2. MD Anderson Cancer Center, University of Texas, Houston, TX, USA

    Robert L. Coleman

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Naumann, R.W., Coleman, R.L. Management Strategies for Recurrent Platinum-Resistant Ovarian Cancer. Drugs 71, 1397–1412 (2011). https://doi.org/10.2165/11591720-000000000-00000

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