Chemotherapy for ovarian cancer: Current concepts

Ovarian cancer is the most common gynecologic cancer and has the highest ca se-fatality rate of all gynecologic malignancies: over one-half of all wome n diagnosed with ovarian cancer die of their disease. Chemotherapy for epit helial ovarian carcinoma has evolved rapidly during the last 15 years. Demo nstrations that combination chemotherapy was superior to single-agent thera py began to improve outcome among women with this disease. By 1990, the adv ent of the platinum compounds had improved response rate, and the new stand ard of care combined platinum with alkylating, agents. Recently, more signi ficant progress has been made with utilization of the taxanes, which demons trate not only improved response rates, but significantly prolonged surviva l as well. The most current clinical trials have established that taxane/pl atinum combination chemotherapy should be the standard of care for epitheli al ovarian cancer. Recent and ongoing studies also address such issues as r elative efficacy of different doses of taxanes and platinum, length of infu sion for the taxanes, and interchangeability of the platinum compounds. Thi s broad overview of the development of current standards of treatment also will address unresolved issues in this field, including intraperitoneal adm inistration of chemotherapy and dose intensification. (C) 1999 Wiley-Liss, Inc.