Cancer Treatment Today

Topotecan is a water-soluble, semisynthetic analogueof camptothecin that inhibits the nuclear enzyme topoisomeraseI. Topotecan has been approved by the U.S. Food and DrugAdministration (FDA) for the treatment of recurrent epithelialovarian cancer and relapsed small cell lung cancer,and has also demonstrated activity in hematologic malignancies and solid tumors including non-small cell lung, cervical, and colon cancers. In ovariancancer, topotecan

Topotecan is a water-soluble, semisynthetic analogueof camptothecin that inhibits the nuclear enzyme topoisomeraseI. Topotecan has been approved by the U.S. Food and DrugAdministration (FDA) for the treatment of recurrent epithelialovarian cancer and relapsed small cell lung cancer,and has also demonstrated activity in hematologic malignancies and solid tumors including non-small cell lung, cervical, and colon cancers. It is no longer experimental.

Lay Summary: IP Chemotherapy is now standard for ovarian cancer. The recommended treatment for ovarian cancer entails primary surgery for diagnosis, staging and cytoreduction (the removal of cancerous mass), followed by chemotherapy. Recommended initial chemotherapy is generally a platinum-and-taxane chemotherapy combination.Intravenous (IV) administration of chemotherapy drugs is done by inserting a needle into a vein in the body of a patient whereas

Paclitaxel is one of the most active agents in the treatment of ovarian carcinoma. Novel agents such as abraxane are solvent free and currently being evaluated to potentially avoid certain patient side effects. Abraxane is an albumin-stabilised nanoparticle formulation of paclitaxel designed to overcome various insolubility problems encountered with paclitaxel. This nano-technology eliminates the need for toxic solvents like cremophor, which limits

The test is investigational, in the sense that experts agree that it needs to be better studied for staging, reataging and surveillacne of ovarian cancer, but it is not routinely recommended by guidelines. Many studies suggest that PET is a more sensitive modality than CT . However, the most recent guideline by Prefontainee et al in 2010 says: “PET is not recommended for staging of ovarian cancer.” It comes to the same conclusion for its use

Lay Summary: Avastin appears to add to combination chemotherapies for ovarian cancer. Patients with ovarian cancer that has recurred or progressed following prior therapies, have unfavorable long-term outcomes with standard therapies. Although additional chemotherapy can be used to treat these patients, they often have minimal anti-cancer responses as well as side effects from treatment. Initial study of Avastin focused on this unfavourable group.

The stage of ovarian cancer is an important prognostic factor that influences survival and the choice of therapy. The quality of the surgical staging is a key determinant of treatment recommendations. Women who have undergone optimal surgical staging, including pelvic and para-aortic lymph node sampling, and have stage I disease may or may not benefit from adjuvant platinum-based chemotherapy. The results of the largest trial comparing adjuvant chemotherapy

Intraperitoneal instillation of interferon has been investigated mostly in ovarian cancer, but also in ascites and pleural effusion of other casues, including colorectal cancer. This is distinct from anti-tumor effects in colon cancer, for which NCCN specifically does not recommed interferon.The effect on the effusion may or may not be related to direct anticancer effect. Unfortunately, none of the studies  included sufficient numbers of patients

The combination of paclitaxel and carboplatin in a three weeks schedule has emerged as the current standard approach for the adjuvant treatment of ovarian cancer.After numerous phase I/II trials of carboplatin and paclitaxel combinations, three large randomized phase III trials were performed comparing cisplatin-paclitaxel with carboplatin-paclitaxel. All three trials demonstrated equivalence with respect to median progression-free survival for carboplatin-paclitaxel

Gemcitabine and carboplatin are not FDa approved in combination for ovarian cancer; however, the combination is supported by randomized clinical trials. Carboplatin is FDA approved in other combinations. The combination is experimental because it is not FDA approved, but medically necessary. Many patients with advanced ovarian cancer will develop recurrent disease. For those patients who have recurrence of disease at least 6 months after initial