Update on the Management of Advanced Ovarian Cancer: the Role of Anti-angiogenic Agents
SB Kaye
Hong Kong J Radiol 2012;15(Suppl):S5-12
Ovarian cancer is often diagnosed in its later stages, leading to poor prognosis and high mortality rates. Chemotherapy with paclitaxel plus a platinum-based drug is the standard treatment for advanced ovarian carcinoma. Angiogenesis plays a key role in normal ovarian function, as well as in the development and progression of ovarian cancer. Anti-angiogenic agents can play a pivotal role in treatment. Bevacizumab is an anti-angiogenic agent with proven efficacy across multiple cancer types. The efficacy of bevacizumab, as a single agent and in combination regimens, has been demonstrated in patients with ovarian cancer. Bevacizumab significantly prolongs progression-free survival when used as first-line therapy for patients with residual disease after surgery, as well as for those with stage IV disease. Research data also support the use of bevacizumab as second-line treatment of patients with platinum-sensitive ovarian cancer. In bevacizumab-naïve patients with platinum-resistant recurrent ovarian cancer, bevacizumab in combination with standard chemotherapy provides significant and clinically meaningful improvements in progression-free survival and objective response rate compared with chemotherapy alone. Other oral anti-angiogenic agents being investigated for the treatment of patients with ovarian cancer include cediranib, sunitinib, pazopanib, sorafenib, nintedanib, and cabozantinib. Current and emerging data for bevacizumab and other anti-angiogenic agents in the management of ovarian cancer are presented in this paper.
中文摘要
治療晚期卵巢癌的最新情況：抗血管新生藥物的角色
SB Kaye
卵巢癌患者在確診時往往已發展至晚期，所以預後較差，死亡率亦較高。化學治療以paclitaxel加上 含鉑藥物是治療晚期卵巢癌的標準方法。血管新生的情況對於卵巢是否能正常運作，以及對其病情 發展和會否惡化都相當重要，所以抗血管新生藥物成為治療關鍵。Bevacizumab是一種抗血管新生藥 物，對於不同種類的癌症都證實有效。無論作為單一治療或合併藥物，bevacizumab都對卵巢癌有療 效。對於術後有殘餘腫瘤和第四期卵巢癌的病人，作為一綫治療的bevacizumab可延長其無惡化生存 期。至於那些對含鉑藥物有效的卵巢癌患者，研究結果亦顯示bevacizumab可作為二綫治療。對含鉑 藥物有抗藥性的卵巢癌復發而未曾接受bevacizumab治療的患者，bevacizumab結合標準化療能顯著改 善其無惡化生存期及客觀反應率，臨床上比只用化療的方法更為有效。其他正進行研究用作治療卵巢癌的口服抗血管新生藥物包括cediranib、sunitinib、pazopanib、sorafenib、nintedanib和cabozantinib。 本文討論bevacizumab和其他抗血管新生藥物用作治療卵巢癌的最新資料。