Prise en charge médicale de la récidive du cancer épithélial de l'ovaire: Medical management of recurrent epithelial ovarian cancer.
Fiche publication
Date publication
décembre 2021
Journal
Bulletin du cancer
Auteurs
Membres identifiés du Cancéropôle Est :
Pr KURTZ Jean-Emmanuel
Tous les auteurs :
Pautier P, Motte-Rouge T, Lécuru F, Classe JM, Ferron G, Floquet A, Kurtz JE, Freyer G, Hardy-Bessard AC
Lien Pubmed
Résumé
The panel of therapeutic options available for medical treatment of relapsed ovarian cancer increased over the last years. In late, platinum-sensitive relapse, standard treatment remains platinum-based polychemotherapy. The choice between bevacizumab added to chemotherapy followed by maintenance and inhibitors of poly-(ADP-riboses) polymerases (PARPi) after response to platinum-based therapy should be discussed, taking into account prior treatment, contraindications, and disease characteristics (biology, symptoms…). The addition of bevacizumab at first platinum-sensitive relapse can be considered if it has not been administered in first line, and it is optional (rechallenge) if previously administered (but without Marketing Authorization in this setting). PARPi are indicated for maintenance therapy after response to platinum-based chemotherapy (whatever the treatment line), regardless of BRCA mutational status, in case of no prior administration. Early relapses are associated with poor prognosis and therapeutic options are more limited. They are treated by monochemotherapy without platinum agents, associated with bevacizumab if not administered previously. Beyond first early relapse, there is no standard and inclusion in a clinical trial should be proposed if possible. Several clinical studies assessing associations of immunotherapy and chemotherapy and/or antiangiogenic drugs and/or targeted therapies (such as PARPi) are ongoing in early or late relapse.
Mots clés
Bevacizumab, Bévacizumab, Cancer de l’ovaire, Early relapse, Inhibiteurs de PARP, Late relapse, Ovarian cancer, PARP inhibitors, Platine résistant, Platine sensible, Platinum-resistant, Platinum-sensitive, Rechute précoce, Rechute tardive
Référence
Bull Cancer. 2021 Dec;108(9S1):S22-S32