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First-Line Systemic Therapy (Chemo/Antiangiogenics)

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Abstract

Epithelial ovarian cancer (EOC) is often diagnosed in advanced stage. Optimal cytoreductive surgery followed by a platinum–taxane combination has been the cornerstone of treatment for more than 15 years. Despite the best upfront treatment, about 80 % of women with advanced disease achieve an objective response, and 10–20 % are cured with this regimen; nevertheless, disease recurrence occurs in most patients. Delaying progression or recurrence is one of the main goals of current ongoing clinical studies. In the last decade, several trials have investigated new therapeutic strategies such as dose-dense chemotherapy, intraperitoneal therapies (IP), and the integration of standard chemotherapy with biological agents. Bevacizumab, targeting angiogenesis, has been the first biological agent reaching the clinical practice. The GOG218 and the ICON7 trials demonstrated that bevacizumab prolongs progression-free survival in patients with FIGO stages IIIb–IV in combination with platinum-based chemotherapy and, most importantly, as maintenance. Other biological drugs, such as pazopanib, olaparib, and trebananib, showing impressive results in the recurrent setting, have been investigated in the first line, pending definitive results. The ovarian cancer is still considered a unique entity. A better molecular characterization will help researchers to develop some more tailored therapeutic strategies according to different molecular subtypes.

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Authors and Affiliations

  1. Division of Medical Oncology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori Fondazione G Pascale – IRCCS, Naples, Italy

    Sandro Pignata & Sabrina Chiara Cecere

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  1. Sandro Pignata
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  2. Sabrina Chiara Cecere
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Correspondence to Sandro Pignata .

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Editors and Affiliations

  1. AP-HP, Hôtel-Dieu, Paris, France

    Eric Pujade-Lauraine

  2. Centre Léon Bérard, Université Claude Bernard, Lyon, France

    Isabelle Ray-Coquard

  3. Chirurgie cancérologique, HEGP, Paris, France

    Fabrice Lécuru

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Pignata, S., Cecere, S.C. (2017). First-Line Systemic Therapy (Chemo/Antiangiogenics). In: Pujade-Lauraine, E., Ray-Coquard, I., Lécuru, F. (eds) Ovarian Cancers. Springer, Cham. https://doi.org/10.1007/978-3-319-32110-3_8

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