Promising new therapies in the treatment of advanced ovarian cancer

✍ Scribed by Carolyn D. Runowicz; Abbie L Fields; Gary L. Goldberg

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 599 KB
• Volume: 76
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19951115)76:10+<2028::aid-cncr2820761320>3.0.co;2-m

✦ Synopsis

Advanced stage ovarian cancer is the most lethal gynecologic cancer. Despite initial response rates of 60-80'/0 with platinum-based chemotherapy, more than 75% of women with this malignancy die of complications associated with this disease. There is a pressing need to find new chemotherapeutic agents for patients with advanced ovarian cancer.

Phase I1 studies have identified paclitaxel as the most active drug in ovarian cancer since the introduction of cisplatin in the 1970s. Phase 111 studies will define the role of paclitaxel as initial therapy. Camptothecins (topotecan, CPT-11, 9-amino-camptothecin) inhibit topoisomerase I. CPT-11 and topotecan have shown activity in Phase I1 trials, Gemcitabine, a pyrimidine antimetabolite, has shown activity in Phase 11 trials. Other promising drugs (docetaxel, treosulfan) are under investigation.

Modulation of drug resistance is being explored in Phase 1/11 studies. Clinical trials have been initiated with buthionine-sulfoximine, an inhibitor of glutathione biosynthesis, which decreases the ability of resistant cells to inactivate platinum compounds and alkylating agents. Cyclosporin has been shown to increase cisplatin cytotoxicity. Phase I trials have demonstrated the feasibility of combining cyclosporin and cisplatin. Phase I1 trials of cyclosporin analogs (PSC 833) and paclitaxel in refractory ovarian cancer are ongoing.

Promising leads in drug development should provide new therapies for patients with ovarian cancer. Further research in the modulation of drug resistance may identify new mechanisms or strategies with which to prevent the emergence of drug resistance. Cancer 1995; 762028- 33.