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Review
. 2021 Jun;32(6):710-725.
doi: 10.1016/j.annonc.2021.02.015. Epub 2021 Mar 3.

The systemic treatment of recurrent ovarian cancer revisited

T Baert  1 , A Ferrero  2 , J Sehouli  3 , D M O'Donnell  4 , A González-Martín  5 , F Joly  6 , J van der Velden  7 , P Blecharz  8 , D S P Tan  9 , D Querleu  10 , N Colombo  11 , A du Bois  12 , J A Ledermann  13
Affiliations
Free article
Review

The systemic treatment of recurrent ovarian cancer revisited

T Baert et al. Ann Oncol. 2021 Jun.
Free article

Abstract

Treatment approaches for relapsed ovarian cancer have evolved over the past decade from a calendar-based decision tree to a patient-oriented biologically driven algorithm. Nowadays, platinum-based chemotherapy should be offered to all patients with a reasonable chance of responding to this therapy. The treatment-free interval for platinum is only one of many factors affecting patients' eligibility for platinum re-treatment. Bevacizumab increases the response to chemotherapy irrespective of the cytotoxic regimen and can be valuable in patients with an urgent need for symptom relief (e.g. pleural effusion, ascites). For patients with recurrent high-grade ovarian cancer, which responds to platinum-based treatment, maintenance therapy with a poly(ADP-ribose) polymerase inhibitor can be offered, regardless of the BRCA mutation status. Here we review contemporary decision-making processes in the systemic treatment of relapsed ovarian cancer.

Keywords: platinum re-treatment; platinum-based chemotherapy; poly(ADP-ribose) polymerase (PARP) inhibitor; recurrent ovarian cancer.

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Conflict of interest statement

Disclosure TB has been an advisor for Tesaro and received research grant from Amgen and non-financial support from Amgen, MSD, Roche and Tesaro, outside the submitted work. JS has reported advisory boards and lectures for PharmaMar, AstraZeneca, Clovis, Roche and Tesaro. AG-M has received consulting fees, lecture fees or travel support from Amgen, AstraZeneca, Clovis Oncology, Genmab, GSK/TESARO, ImmunoGen, Mersana, Merck Sharp & Dohme, Novartis, Oncoinvent, Pfizer/Merck, PharmaMar, Roche and Sotio. FJ reports expertise, board fees and travel support from AZ, GSK, BMS, Clovis, Pfizer, Astellas, Merck, MSD, Ipsen, Novartis, Sanofi and Baxter. PB has received consultancy, travel and lecture fees and honoraria from AstraZeneca, Roche and GSK and has received research funding from AstraZeneca. DSPT is funded by the Singapore Ministry of Health's National Medical Research Council under the Clinician Scientist Award (NMRC/CSA—INV/0016/2017) and has received consultancy fees and honoraria from AstraZeneca, Bayer, Eisai, Genmab, Merck, MSD, Roche and Tessa; and has received research funding from AstraZeneca, Bayer and Karyopharm. NC has reported advisory roles for Roche, PharmaMar, AstraZeneca, Clovis, Tesaro, Pfizer, Takeda and Biocad and speaker's honoraria from Roche, PharmaMar, AstraZeneca and Tesaro. AdB has received grants and personal fees from Roche, Astra Zeneca, Tesaro, Clovis, Pfizer, Biocad, Genmab/Seattle Genetics and MSD, outside the submitted work. JAL reports advisory boards and/or lecture fees from AstraZeneca, GSK, Artios Pharma, Clovis Oncology, MSD/Merck, Amgen, Pfizer and Eisai. Grant funding: AstraZeneca, MSD/Merck. IDMC fees: Regeneron. All other authors have declared no conflicts of interest.

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