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What Are the Treatment Options for Recurrent Ovarian Cancer?

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Controversies in the Management of Gynecological Cancers

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Abstract

Most women with advanced ovarian cancer will suffer a recurrence. There are many therapeutic options to consider at relapse, and it is the careful selection and use of chemotherapy and sometimes surgery that has over the last decade extended survival. Debulking surgery at relapse is currently undertaken with careful patient selection, but ongoing randomized trials will identify whether this approach is worthwhile and which patient will benefit. There are now many options for patients with “platinum-sensitive” recurrence, and combination therapy has been shown to be superior to single-agent platinum therapy. The term “platinum resistance” needs careful consideration, and treatment decisions for “platinum-resistant” disease are more difficult due to the heterogeneity of the condition. Molecular targeted therapy directed against angiogenesis, inherited and acquired defects of DNA repair, and intracellular signaling pathways are showing promise. Antiangiogenic agents and PARP inhibitors are the leading classes of compounds targeting molecular pathways. The incorporation of these and other agents will require carefully designed and conducted clinical studies to establish their place in the treatment pathway.

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Authors and Affiliations

  1. UCL Cancer Institute, University College London, Cancer Research UK and UCL Cancer Trials Centre, 90 Tottenham Court Road, London, W1T 4TJ, UK

    Jonathan A. Ledermann BSc, MD, FRCP & Fharat A. Raja MRCP

  2. Department of Gynecology and Gynecological Oncology, Kliniken Essen Mitte, Henricistrasse 92, Essen, 45136, Germany

    Philipp Harter MD

  3. Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte/Evangel Huyssensstiftung, Henricistrasse 92, Essen, 45136, Germany

    Florian Heitz MD

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  1. Jonathan A. Ledermann BSc, MD, FRCP
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  2. Fharat A. Raja MRCP
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  3. Philipp Harter MD
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Correspondence to Jonathan A. Ledermann BSc, MD, FRCP .

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  1. UCL Cancer Institute, University College London, London, United Kingdom

    Jonathan A. Ledermann

  2. Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands

    Carien L. Creutzberg

  3. Royal Women’s Hospital, The University of Melbourne, Melbourne, Australia

    Michael A. Quinn

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Ledermann, J.A., Raja, F.A., Harter, P., Heitz, F. (2014). What Are the Treatment Options for Recurrent Ovarian Cancer?. In: Ledermann, J., Creutzberg, C., Quinn, M. (eds) Controversies in the Management of Gynecological Cancers. Springer, London. https://doi.org/10.1007/978-0-85729-910-9_10

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