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Medical Oncology

, 34:103 | Cite as

A brief review of the management of platinum-resistant–platinum-refractory ovarian cancer

  • Bryan Oronsky
  • Carolyn M. Ray
  • Alexander I. Spira
  • Jane B. Trepel
  • Corey A. Carter
  • Hope M. Cottrill
Review Article

Abstract

Ovarian cancer, which ranks fifth in cancer deaths among women, is the most lethal gynecologic malignancy. Epithelial ovarian cancer (EOC) is the most common histologic type, with the 5-year survival for all stages estimated at 45.6%. This rate increases to more than 70% in the minority of patients who are diagnosed at an early stage, but declines to 35% in the vast majority of patients diagnosed at advanced stage. Recurrent EOC is incurable. Platinum sensitivity (or lack thereof) is a major determinant of prognosis. The current standard treatment is primary surgery followed by platinum-based chemotherapy. In recurrent platinum-resistant/platinum-refractory EOC, sequential single-agent salvage chemotherapy is superior to multiagent chemotherapy. Multiagent regimens increase toxicity without clear benefit; however, no preferred sequence of single agents is recommended. The impact of targeted therapies and immunotherapies on progression-free survival and overall survival, which remains dismal, is under active investigation. Currently, clinical trials offer the best hope for the development of a new treatment paradigm in this recalcitrant disease.

Keywords

Epithelial ovarian cancer Platinum resistant Platinum refractory Epigenetic VEGF inhibitor 

Notes

Acknowledgements

The authors wish to thank and acknowledge Dr. Harry Lybeck, possibly the world’s longest living academic professor and physician, currently 98 years old (and counting), for his contributions to this manuscript. Having earned his M.D. and Ph.D. while serving in WWII, Dr. Lybeck climbed to the top of the academic hill but is far from over it. With 70 years of medical experience, Dr. Lybeck is the epitome of a caring, compassionate physician who prioritizes others over himself.

Compliance with ethical standards

Conflict of interest

None

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Bryan Oronsky
    • 1
  • Carolyn M. Ray
    • 2
  • Alexander I. Spira
    • 3
  • Jane B. Trepel
    • 4
  • Corey A. Carter
    • 5
  • Hope M. Cottrill
    • 6
  1. 1.EpicentRx IncSan DiegoUSA
  2. 2.Saint Francis Medical GroupHartfordUSA
  3. 3.Virginia Cancer SpecialistsFairfaxUSA
  4. 4.Developmental Therapeutics Branch NIHBethesdaUSA
  5. 5.Walter Reed National Military Medical CenterBethesdaUSA
  6. 6.Baptist Health Medical Group, Gynecologic OncologyLexingtonUSA

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