Aktuelle Aspekte der Therapie des platinresistenten Ovarialkarzinoms

Zusammenfassung

Die Operation mit dem Ziel der maximalen Tumorreduktion gefolgt von einer systemischen Chemotherapie mit Paclitaxel und Carboplatin sind die entscheidenden Therapieschritte im Management von fortgeschrittenem Ovarialkarzinom. Trotz der hohen Ansprechraten auf die Chemotherapie rezidiviert der Großteil der Patientinnen. Für die Therapiewahl in der Rezidivsituation ist besonders das therapiefreie Intervall von Relevanz. Für Patientinnen mit einem platinresistenten Ovarialkarzinom werden zwar verschiedene Therapiemodalitäten wie Chemotherapie und Hormontherapie eingesetzt, die Ansprechraten sind jedoch sehr unbefriedigend. Auf Basis von publizierten Studien und aktueller Leitlinien werden die einzelnen Therapieoptionen diskutiert und auch neue zielgerichtete Therapieansätze vorgestellt.

Abstract

Surgery and chemotherapy form the cornerstone of the primary treatment for advanced ovarian cancer. Currently, the standard of care for primary ovarian cancer is platinum and taxane-based therapy. Despite the favorable response, however, most women with advanced-stage ovarian cancer will relapse. The treatment-free interval after adequate front-line therapy is particularly important for the therapy strategy for relapsed ovarian cancer. Various treatment options are available for patients with platinum resistance who suffer a relapse within 6 months after primary therapy, but there is no clear consensus about how these patients should be managed. Options include palliative surgery, chemotherapy and hormone therapy. The choice of treatment and the form in which any or all of these options should be administered to an individual patient have not yet been standardized and are the subjects of ongoing clinical trials. Based on randomized trials this article gives an overview of the various treatment modalities and discusses new targeted therapies.

Schlüsselwörter

Ovarialkarzinom - Platinresistenz - Chemotherapie

Key words

ovarian cancer - platinum resistance - chemotherapy

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