Clinical Trials in Ovarian Cancer

Christine S. Walsh

• Publisher: Rutgers University Press Medicine
• Year: 2017
• Print ISBN: 9780813586472
• eBook ISBN: 9780813586489
• Edition: 1
• Topic: Medicine
• Subtopic: Gynecology, Obstetrics & Midwifery

When a patient is diagnosed with a gynecological malignancy, she and her doctors must make urgent, high-risk decisions about her course of treatment. In selecting an appropriate plan of care, physicians must weigh the patient’s individual needs, the tumor’s specific characteristics, and the treatment’s potential side effects. Because there is no one-size-fits-all treatment solution, a plethora of clinical trials have been performed on ovarian cancer patients, but clinicians may struggle to keep up with this ever-growing body of research.      Collecting and synthesizing research findings from a wide array of medical journal articles and book chapters, Clinical Trials in Ovarian Cancer provides physicians with an invaluable resource. Gynecologic oncologist Christine S. Walsh systematically outlines each of the seminal Phase III trials that have shaped the treatment of ovarian cancers, detailing the rationale for the trial, the patient population studied, treatment delivery methods, efficacy, toxicity, and trial conclusions. She provides a clear overview of established treatments, as well as still-controversial experimental approaches.    The first book to organize this cutting-edge research into an easy-to-use reference, Clinical Trials in Ovarian Cancer should help medical personnel at all levels provide their patients with the highest standard of care.   

CHAPTER 1

Early Stage Epithelial Ovarian Cancer

Approximately 30% of epithelial ovarian cancers are diagnosed at an early stage and can be completely resected at the time of surgery. GOG 7601 defined low-risk tumors that include stage IA and IB, grade 1 cancer, where adjuvant chemotherapy can be safely omitted. High-risk early-stage ovarian cancers include stage I, grade 3; stage IC; clear cell; and stage II cancers. In this high-risk subgroup, the GICOG and GOG 95 trials demonstrated a lower risk of recurrence with the administration of platinum-based adjuvant chemotherapy. The ACTION and ICON1 trials demonstrated improved overall survival with platinum chemotherapy (mostly carboplatin) compared to observation but suggested that the benefit does not apply to patients who had complete surgical staging. GOG 157 showed no difference in survival between 3 and 6 cycles of carboplatin and paclitaxel, but an exploratory analysis suggested a benefit for 6 cycles with serous histologies.

GOG 7601 (Young, NEJM 1990)

REFERENCE

• Young RC, et al. Adjuvant therapy in stage I and stage II epithelial ovarian cancer. Results of two prospective randomized trials. N Engl J Med. 1990;322(15):1021-1027. PMID: 2181310. (Young et al. 1990)

TRIAL SPONSORS

• Ovarian Cancer Study Group (Mayo Clinic, MD Anderson Hospital and Tumor Institute, National Cancer Institute, Roswell Park Memorial Institute)
• Gynecologic Oncology Group (GOG)

RATIONALE FOR TRIAL

• Survival rates vary among patients with early-stage epithelial ovarian cancer. The 5-year survival ranges from 50% to 70% for patients with stage I ovarian cancer. The 5-year survival ranges from 38% to 60% for patients with stage II ovarian cancer.
• Pathologic factors such as cell type and grade only partially account for the variable survivals.
• Earlier studies have demonstrated the importance of thorough surgical sta...

Table of contents

• Cover
• Title Page
• Copyright
• Dedication
• Contents
• List of Tables
• Preface and Acknowledgments
• 1. Early Stage Epithelial Ovarian Cancer
• 2. Advanced Stage Epithelial Ovarian Cancer: Adjuvant Chemotherapy
• 3. Advanced Stage Epithelial Ovarian Cancer: Timing of Surgery and Interval Cytoreduction
• 4. Epithelial Ovarian Cancer: Maintenance Therapy
• 5. Recurrent Epithelial Ovarian Cancer
• Abbreviations
• References
• Index
• About the Author