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Gynecologic Cancer

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Side Effects of Medical Cancer Therapy

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Abstract

Ovarian cancer is the second most common ­gynecologic malignancy, with 204,000 new cases of ovarian cancer per year worldwide, including about 43,000 cases in Europe and 22,000 in the United States. In the industrialized world, a large number of these women will survive their cancer. There have been improvements in outcomes after surgery, chemotherapy, and radiation therapy; however, patients do experience significant treatment-related side effects.

Besides the classical cytotoxic agents and hormonal agents, now used for many years, the development of the newer molecular targeted agents is currently an exciting area of interest in the care of patients with gynecologic malignancies.

Angiogenesis seems to play an important role in gynecologic cancer pathogenesis, and elevated levels of angiogenesis markers seem to be correlated with a worse outcome. Agents that target single or multiple pathways alone or in combination with chemotherapy are currently under study. Bevacizumab, a monoclonal antibody targeting the vascular endothelial growth factor, and the oral tyrosine kinase inhibitors such as sorafenib, sunitinib, and pazopanib are under investigation, both in the primary disease setting and in the recurrent/metastatic setting.

Challenges are careful patient and drug selection for ­optimizing the combination of drugs in order to obtain optimal efficacy. The latter depends on several factors: (1) the drugs used must be active as single agents against the particular tumor; (2) the drugs should have different mechanisms of action to minimize emergence of drug resistance; (3) the drugs should have a biochemical basis of at least additive and preferably synergistic effects; (4) the drugs chosen should have a different spectrum of toxicity so they can be used for maximum cell kill at full doses; and (5) the drugs chosen should be administered intermittently so that cell kill is enhanced and prolonged immunosuppression is minimized. This chapter gives an overview of the currently used treatment modalities in gynecologic cancer, their side effects, and their management.

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Authors and Affiliations

  1. Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium

    Sevilay Altintas M.D., Ph.D. & Jan B. Vermorken M.D., Ph.D.

  2. Department of Medical Oncology, Ziekenhuisnetwerk Antwerpen-Middelheim, Antwerp, Belgium

    Dirk L. A. L. Schrijvers M.D., Ph.D.

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  1. Sevilay Altintas M.D., Ph.D.
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  2. Dirk L. A. L. Schrijvers M.D., Ph.D.
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  3. Jan B. Vermorken M.D., Ph.D.
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Correspondence to Jan B. Vermorken M.D., Ph.D. .

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  1. , Department of Hematology-Oncology, Centre Hospitalier de Luxembourg, Rue Barble 4, Luxembourg, 1210, Luxembourg

    Mario A. Dicato

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Altintas, S., Schrijvers, D.L.A.L., Vermorken, J.B. (2013). Gynecologic Cancer. In: Dicato, M. (eds) Side Effects of Medical Cancer Therapy. Springer, London. https://doi.org/10.1007/978-0-85729-787-7_5

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