Systemtherapie des Ovarialkarzinoms

Die Systemtherapie beim fortgeschrittenen Ovarialkarzinom besteht in der Regel aus einer Kombination aus Carboplatin und Paclitaxel über 6 Zyklen – in den Stadien FIGO IIIB und IV zusätzlich erweitert um Bevacizumab. Rezidive werden entsprechend ihrer Platinsensitivität erneut platinhaltig behandelt oder bei Resistenz mit einer Monochemotherapie anderer Wirkstoffe. Liegt eine BRCA-1/2-Mutation vor, wird um einen PARP-Inhibitor ergänzt.

Schlüsselwörter

Ovarialkarzinom - adjuvante Therapie - Carboplatin - Paclitaxel - Bevacizumab

• Literatur

• 1 McGuire WP, Hoskins WJ, Brady MF. et al. Cyclophosphamide and cisplatin compared with paclitaxel and cisplatin in patients with stage III and stage IV ovarian cancer. N Engl J Med 1996; 334: 1-6
• 2 Piccart MJ, Bertelsen K, James K. et al. Randomized intergroup trial of cisplatin-paclitaxel versus cisplatin-cyclophosphamide in women with advanced epithelial ovarian cancer: three-year results. J Natl Cancer Inst 2000; 92: 699-708
• 3 Burger RA, Brady MF, Bookman MA. et al. Incorporation of bevacizumab in the primary treatment of ovarian cancer. N Engl J Med 2011; 365: 2473-2483
• 4 Burger RA, Brady MF, Rhee J. et al. Independent radiologic review of GOG218, a phase III trial of bevacizumab (BEV) in the primary treatment of advanced epithelial ovarian (EOC), primary peritoneal (PPC) or fallopian tube cancer (FTC). J Clin Oncol 2011; 29 (Suppl.) Abstract 5023
• 5 Perren T, Swart AM, Pfisterer J. et al. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med 2011; 365: 2484-2496
• 6 MASCC/ESMO Leitlinie 2016.
• 7 Leitlinienprogramm Onkologie/S3 Leitlinie Ovarialkarzinom Kurzversion/Oktober 2016.
• 8 Du Bois A, Reuss A, Pujade-Lauraine E. et al. Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe dʼInvestigateurs Nationaux Pour les Etudes des Cancers de lʼOvaire (GINECO). Cancer 2009; 115: 1234-1244
• 9 Pujade-Lauraine E, Wagner U, Avall-Lundqvist E. et al. Pegylated liposomal doxorubicin and carboplatin compared with paclitaxel and carboplatin for patients with platinum-sensitive ovarian cancer in late relapse. J Clin Oncol 2010; 28: 3323-3329
• 10 Aghajanian C, Blank SV, Goff BA. et al. OCEANS: A randomized, double-blind, placebo-controlled phase III trial of chemotherapy with or without bevacizumab in patients with platinum-sensitive recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer. J Clin Oncol 2012; 30: 2039-2045
• 11 Pujade-Lauraine E, Hilpert F, Weber B. et al. Bevacizumab combined with chemotherapy for platinum-resistant recurrent ovarian cancer: The AURELIA open-label randomized phase III trial. J Clin Oncol 2014; 32: 1302-1308
• 12 Stockler MR, Hilpert F, Friedlander M. et al. Patient-reported outcome results from the open-label phase III AURELIA trial evaluating bevacizumab-containing therapy for platinum-resistant ovarian cancer. J Clin Oncol 2014; 32: 1309-1316
• 13 Lorusso D, Ferrandind G, Fruscella E. et al. Gemcitabine in epithelial ovarian cancer treatment: current role and future perspectives. Int J Gynecol Cancer 2005; 15: 1002-1013
• 14 Fong PC, Yap TA, Boss DS. et al. Poly(ADP)-ribose polymerase inhibition: frequent durable responses in BRCA carrier ovarian cancer correlating with platinum-free interval. J Clin Oncol 2010; 28: 2512-2519
• 15 Kaye B, Lubinski J, Matulonis U. et al. Phase II, open-label, randomized, multi-center study comparing the efficacy and safety of olaparib, a poly(ADP-ribose) polymerase inhibitor and peglyated liposomal doxorubicin in patients with BRCA1 or BRCA2 mutations and recurrent ovarian cancer. J Clin Oncol 2012; 30: 372-379
• 16 Gelmon KA, Tischkowitz M, Mackay H. et al. Olaparib in patients with recurrent high-grade serous or poorly differentiated ovarian carcinoma or triple-negative breast cancer: a phase 2, multicentre, open-label, non-randomised study. Lancet Oncol 2011; 12: 852-861
• 17 Ledermann J, Harter P, Gourley C. et al. Olaparib maintenance therapy in platinum-sensitive relapsed ovarian cancer. N Engl J Med 2012; 366: 1382-1392