TY - JOUR
T1 - Traitement médical de première ligne du cancer épithélial de l'ovaire de haut grade
T2 - First-line medical treatment of high-grade epithelial ovarian cancer
AU - pour le groupe GINECO
AU - Selle, Frédéric
AU - Alexandre, Jérôme
AU - Prulhière, Karine
AU - Kalbacher, Elsa
AU - Ray-Coquard, Isabelle
AU - Leary, Alexandra
N1 - Publisher Copyright:
© 2021 Société FranÇaise du Cancer. Publié par Elsevier Masson SAS. Tous droits réservés.
PY - 2021/12/1
Y1 - 2021/12/1
N2 - In early stages, standard treatment is adjuvant chemotherapy, consisting of platinum-based combination for 6 cycles, especially in serous and endometrioid high grade carcinomas. In advanced stages, indication of neoadjuvant chemotherapy must be discussed on a case-by-case basis in multidisciplinary meetings (MDM). Bevacizumab can also be considered in the neoadjuvant setting in some circumstances, always after discussion in MDM. Carboplatin plus paclitaxel every 21 days, with or without bevacizumab remains the standard of care for first-line chemotherapy. Inhibitors of poly-(ADP-riboses) polymerases (PARPi) have been approved and are reimbursed as maintenance monotherapy in tumors carrying BRCA1 or BRCA2 mutation after complete or partial response to chemotherapy. Two recent studies demonstrated the efficacy of PARPi on progression free survival, one for niraparib single-agent in patients with high-grade ovarian carcinoma regardless of BRCA status, the other one for the combination of bevacizumab and olaparib in patients with high grade carcinoma, with positive test for homologous recombination DNA repair deficiency (regardless of BRCA status). These two new modalities of maintenance therapy are now available in compassionate use programs or post compassionate use programs. Depending on pending decisions upon reimbursement, these indications might be somewhat modified.
AB - In early stages, standard treatment is adjuvant chemotherapy, consisting of platinum-based combination for 6 cycles, especially in serous and endometrioid high grade carcinomas. In advanced stages, indication of neoadjuvant chemotherapy must be discussed on a case-by-case basis in multidisciplinary meetings (MDM). Bevacizumab can also be considered in the neoadjuvant setting in some circumstances, always after discussion in MDM. Carboplatin plus paclitaxel every 21 days, with or without bevacizumab remains the standard of care for first-line chemotherapy. Inhibitors of poly-(ADP-riboses) polymerases (PARPi) have been approved and are reimbursed as maintenance monotherapy in tumors carrying BRCA1 or BRCA2 mutation after complete or partial response to chemotherapy. Two recent studies demonstrated the efficacy of PARPi on progression free survival, one for niraparib single-agent in patients with high-grade ovarian carcinoma regardless of BRCA status, the other one for the combination of bevacizumab and olaparib in patients with high grade carcinoma, with positive test for homologous recombination DNA repair deficiency (regardless of BRCA status). These two new modalities of maintenance therapy are now available in compassionate use programs or post compassionate use programs. Depending on pending decisions upon reimbursement, these indications might be somewhat modified.
KW - Bevacizumab
KW - Chemotherapy
KW - First line
KW - Ovarian cancer
KW - PARP inhibitors
UR - http://www.scopus.com/inward/record.url?scp=85121624648&partnerID=8YFLogxK
U2 - 10.1016/S0007-4551(21)00582-8
DO - 10.1016/S0007-4551(21)00582-8
M3 - Article
C2 - 34955161
AN - SCOPUS:85121624648
SN - 0007-4551
VL - 108
SP - S5-S12
JO - Bulletin du Cancer
JF - Bulletin du Cancer
IS - 9
ER -