scholarly journals Do all patients with recurrent ovarian cancer need systemic therapy?

Cancer ◽  
2019 ◽  
Vol 125 (S24) ◽  
pp. 4602-4608
Author(s):  
Michael L. Friedlander
Keyword(s):  
Ovarian Cancer ◽  
Systemic Therapy ◽  
Recurrent Ovarian Cancer

Systemic therapy in recurrent ovarian cancer: current treatment options and new drugs

2010 ◽  
Vol 10 (1) ◽  
pp. 81-88 ◽  
Author(s):  
Philipp Harter ◽  
Felix Hilpert ◽  
Sven Mahner ◽  
Florian Heitz ◽  
Jacobus Pfisterer ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Systemic Therapy ◽  
Treatment Options ◽  
Recurrent Ovarian Cancer ◽  
Current Treatment ◽  
New Drugs

Use of systemic therapy in women with recurrent ovarian cancer—Development of a national clinical practice guideline

2007 ◽  
Vol 106 (1) ◽  
pp. 181-192 ◽  
Author(s):  
L. Elit ◽  
L. Zitzelsberger ◽  
M. Fung-Kee-Fung ◽  
M. Brouwers ◽  
I.D. Graham ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Clinical Practice ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Systemic Therapy ◽  
Recurrent Ovarian Cancer ◽  
Cancer Development

scholarly journals Systemic therapy for recurrent epithelial ovarian cancer: a clinical practice guideline

2017 ◽  
Vol 24 (6) ◽  
pp. 540 ◽  
Author(s):  
J. Francis ◽  
N. Coakley ◽  
L. Elit ◽  
H. Mackay ◽  
And the Gynecologic Cancer Disease Site Group
Keyword(s):  
Ovarian Cancer ◽  
Clinical Practice ◽  
Epithelial Ovarian Cancer ◽  
Systemic Therapy ◽  
Symptom Control ◽  
Progression Free Survival ◽  
Recurrent Ovarian Cancer ◽  
The Body ◽  
Net Benefit ◽  
Eligibility Criteria

Objective The purpose of this guideline is to recommend systemic therapy options for women with recurrent epithelial ovarian cancer, including fallopian tube and primary peritoneal cancers.Methods This document updates the recommendations published in the 2011 Optimal Chemotherapy for Recurrent Ovarian Cancer guideline from Cancer Care Ontario. Draft recommendations were formulated based on evidence obtained through a systematic review of phase ii and iii randomized controlled trials (rcts). The draft recommendations underwent internal review by clinical and methodology experts, and external review by clinical practitioners through a survey assessing the clinical relevance and overall quality of the guideline. Feedback from the internal and external reviews was integrated into the clinical practice guideline.Results The primary literature search yielded thirty-six primary research papers representing thirty rcts that met the eligibility criteria. The guideline provides recommendations for patients with serous tumour histologies and with recurrent, platinum-resistant, and platinum-sensitive ovarian cancer.Conclusions The body of evidence from trials that included olaparib and bevacizumab consistently shows a benefit in progression-free survival (pfs) without a corresponding benefit in overall survival (os). The Working Group for this guideline designated pfs, which is associated with symptom control, as a critical outcome. A finding of net benefit can therefore be concluded based on significant differences in pfs. However, that benefit is not without identified harms. Given the identified harms, patient involvement in the decision-making process must take into consideration the side effect profiles of olaparib and bevacizumab within the context of improved pfs but minimal change in os.

Efficacy and safety of stereotactic body radiotherapy (SBRT) in oligometastatic/persistent/recurrent ovarian cancer: a prospective, multicenter phase II study (MITO-RT3/RAD)

2021 ◽  
pp. ijgc-2021-002709
Author(s):  
Gabriella Macchia ◽  
Barbara Alicja Jereczek-Fossa ◽  
Roberta Lazzari ◽  
Annamaria Cerrotta ◽  
Francesco Deodato ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Phase Ii ◽  
Primary Endpoint ◽  
Systemic Therapy ◽  
Stereotactic Body Radiotherapy ◽  
Phase Ii Study ◽  
Complete Response ◽  
Recurrent Ovarian Cancer ◽  
Severe Toxicity ◽  
Multicenter Phase

BackgroundStereotactic body radiotherapy (SBRT) has shown promising results in the clinical setting of oligometastatic, persistent, or recurrent disease in several malignancies including ovarian cancer.Primary ObjectiveThe MITO-RT3/RAD trial is a prospective, multicenter phase II study aimed at identifying potential predictors of response and clinical outcome after SBRT treatment.Study HypothesisRadiotherapy delivered by pre-defined SBRT treatment schedules and shared constraints could improve the rate of complete response.Trial DesignAll patients accrued will be treated with a radiotherapy dose in the range of 30–50 Gy by 1, 3, or 5 SBRT daily fractions to all sites of active metastatic disease according to diagnostic imaging. Schedules of treatment and dose prescription have been established before considering target sites and healthy organ dose constraints. Follow-up and monitoring of side effects will be carried out every 3 months for the first year with imaging and clinical evalutation, and every 4 months within the second year; thereafter, surveillance will be carried out every 6 months. The best response on a per lesion basis will be evaluated by computed tomographic (CT) scan, positron emission tomography/CT, or magnetic resonance imaging in case of brain lesions, every 3 months.Major Inclusion/Exclusion CriteriaThe study includes patients with oligometastatic, persistent, or recurrent ovarian cancer for which salvage surgery or other local therapies are not feasible due to any relative contra-indication to further systemic therapy because of serious co-morbidities, previous severe toxicity, unavailability of potentially active systemic therapy, or patient refusal.Primary EndpointThe primary endpoint of the study is the clinical complete response rate to SBRT by imaging on a per lesion basis.Sample SizeApproximately 205 lesions will be treated (90 lymph nodes and 115 parenchyma lesions).Estimated Dates for Completing Accrual and Presenting ResultsFifty-two centers have expressed their intention to participate. Enrollment should be completed by March 2023 and analysis will be completed in September 2023.Trial RegistrationNCT04593381.

Use of systemic therapy in women with recurrent ovarian cancer—Development of a national clinical practice guideline

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16033-16033
Author(s):  
L. Elit ◽  
L. Zitzelberger ◽  
M. Fung Kee Fung ◽  
M. Brouwers ◽  
I. D. Graham ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Health Care ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Systemic Therapy ◽  
Recurrent Ovarian Cancer ◽  
Decision Makers ◽  
Care Providers ◽  
Overall Response ◽  
Canadian Context

16033 Background: To develop a national guideline on the use of systemic therapy for women with recurrent ovarian cancer. Methods: In March 2005, the Society of Gynecologic Oncologists of Canada (GOC) held a workshop with clinicians and methodologists to begin the process of defining specific recommendations for the management of recurrent ovarian cancer in the Canadian context. An adaptation process developed by the Canadian Strategy for Cancer Control (CSCC) Clinical practice Guidelines Action Group (CPG-AG) was used. Guideline adaptation modifies existing guidelines to fit a local organizational and cultural context. A draft guideline was developed and sent to practitioners from across Canada for feedback. Relevant comments were incorporated. Results: A literature review identified seven guidelines which were assessed for quality by six reviewers using the AGREE instrument. Data on guideline quality, currency and content (recommendations) was used by the pan-Canadian panel in an informal consensus process which resulted in the initial draft of a guideline. A sub-panel reviewed the draft and made further edits to ensure the guideline's appropriateness for a national context. Practitioner feedback was requested from 165 health care providers who treat ovarian cancer from across Canada. Overall response rate was 37%. Respondents included gynecologic oncologists (62.5%), medical oncologists (25%), radiation oncologists (3%), internal medicine (3%), gynecologists (1%) and psychosocial oncology (1%). Overall response to the guideline was positive. All comments were reviewed by the sub-panel and the guideline was edited appropriately. Conclusions: This was the first undertaking of the creation of an interdisciplinary guideline in gynecologic oncology with input from health care providers from across Canada. Feedback from the panel and external practitioners indicated that this was a worthwhile process. Our goal was to vet this work in the Canadian context so as to inform provincial decision-makers concerning access to expensive systemic therapy. The guideline has been endorsed by the national organization and will be available to practitioners and decision makers on the organization's website. No significant financial relationships to disclose.

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