Ovarian cancer is the most lethal gynecological cancer in women in the western world with a 5-year survival of 49.7%. Advanced
stage ovarian cancer is treated both surgically and with chemotherapy, but despite initial high response rates of 60- 75%, many
women experience disease recurrence with a dismal prognosis, 5 year overall survival for FIGO stage IIIc and IV disease being only 32
and 18%. In an attempt to improve outcome for both primary and recurrent disease, dose-intense and dose-dense chemotherapy regimens
have been investigated. This overview summarizes these results in first and second-line treatment. In first-line treatment, no benefit was
found of dose-intense regimes in the majority of the studies, only toxicity was increased. However, results are conflicting with the recent
Japanese Gynecologic Oncology Group (JGOG) trial showing an improved progression free and overall survival in patients treated with
dose-dense weekly paclitaxel combined with standard 3-weekly carboplatin. For recurrent disease dose-dense weekly combination chemotherapy
seems to be very effective in patients with platinum-resistant ovarian cancer. Several phase II studies showed an increase in
response rate, progression free survival and overall survival for dose-dense paclitaxel and carboplatin, compared to results of nonplatinum
chemotherapy. In platinum-sensitive ovarian cancer, on contrary, the results of weekly paclitaxel and carboplatin seem to be
comparable with standard 3-weekly regimens.
Keywords: Ovarian cancer, paclitaxel, carboplatin, dose-dense, dose-intense, weekly chemotherapy, platinum-resistant, Japanese Gynecologic Oncology Group (JGOG), progression free survival, overall survival.
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