Update on the utility of prognostic biomarkers in ovarian cancer

There is considerable interest in the gynecologic cancer community for the development of biomarkers that will be of utility in routine management of women with advanced ovarian cancer. However, at the present time, there remains limited evidence for the usefulness of any such test other than the serum cancer antigen (CA)-125 level, employed to monitor the course of disease in response to treatment or during periods of observation

Pegylated liposomal doxorubicin: appraisal of its current role in the management of epithelial ovarian cancer

Pegylated liposomal doxorubicin (PLD) has become a major component in the routine management of epithelial ovarian cancer. The drug is frequently employed as a single agent in the platinum-resistant setting, and recently reported data reveal the superiority of the combination of PLD plus carboplatin, compared with the platinum drug plus paclitaxel, in delaying the time to disease progression in women with recurrent (potentially platinum-sensitive) disease. Current research efforts involving PLD in ovarian cancer are focusing on adding novel targeted drugs to this cytotoxic agent. The utility of such approaches in the platinum-resistant population, compared with the sequential administration of single agents active in this setting, remains to be determined

Involvement of Bone in Epithelial Ovarian Cancer: Case Report of an Uncommon Late Metastatic Event

Bone involvement is uncommon in epithelial ovarian cancer. In this report, a case of bone metastases from ovarian cancer is described and the potential risk factors for such a rare occurrence are discussed. It is possible that such an event will become more common in the future as patients with advanced ovarian cancer experience prolonged survival but the cancer is not eliminated

Withholding Recognized Effective Adjuvant Anti-Neoplastic Chemotherapy in a Setting with Known Highly Active Treatment for Recurrent Disease: A Case Report

A young woman presenting with an ovarian immature teratoma (stage IA, grade 2) demonstrates the dilemma associated with the decision to withhold adjuvant chemotherapy of documented clinical utility in a setting where highly effective treatment is available should the cancer ultimately recur

Is It Time to Inform This Patient that Further Antineoplastic Drug Therapy Will Not Be of Clinical Value?

A woman with heavy pre-treated ovarian cancer sought consultation regarding additional treatments. The case raises the vexing question of whether there may be a time in the course of the disease process where it is most appropriate to state further anti-neoplastic therapy will not be of clinical utility

Intraperitoneal chemotherapy in the management of ovarian cancer: focus on carboplatin

Both pre-clinical studies and phase 1–2 clinical trials have provided strong support for the potential role of regional drug delivery in the management of epithelial ovarian cancer, a disease process whose major manifestations remain largely localized to the peritoneal cavity in the majority of individuals with this malignancy. The results of 3 phase 3 randomized trials have revealed the favorable impact of primary cisplatin-based intraperitoneal chemotherapy in women who initiate drug treatment with small-volume residual ovarian cancer following an attempt at optimal surgical cytoreduction. Concerns have been raised regarding the toxicity of regional treatment, particularly the side-effect profile associated with cisplatin. One rational approach to improving the tolerability of intraperitoneal chemotherapy is to substitute carboplatin for cisplatin. This review discusses the rationale for and data supporting regional treatment of epithelial ovarian cancer, and highlights the potential role for intraperitoneal carboplatin in this clinical setting

Recent studies that influence the chemotherapeutic paradigm in the management of advanced ovarian cancer

Several recently reported evidence-based phase 3 trials that focus on the role of cytotoxic chemotherapy have the potential to strongly influence the care of women with advanced epithelial ovarian cancer. Particular areas of interest include: (a) neoadjuvant chemotherapy; (b) chemotherapy of recurrent platinum-sensitive ovarian cancer; and (c) the relevance of paclitaxel scheduling in the primary chemotherapeutic management of the malignancy. This report will briefly discuss the results of these studies and the potential implications of the findings for routine care of patients in these clinical settings

Major Clinical Impact of Platinum-Based Chemotherapy in a Patient with a Borderline Ovarian Cancer

A patient with extensive and painful chest wall involvement from a metastatic borderline cancer of the ovary was treated with a carboplatin plus paclitaxel chemotherapy regimen. She achieved a rather dramatic improvement of pain control, a significant biochemical response with 75% reduction of the CA-125 antigen level, but only limited radiographic tumor regression. This experience emphasizes the potential clinical utility of platinum-based cytotoxic chemotherapy in the setting of symptomatic advanced borderline ovarian cancer