Trabectedin for the treatment of ovarian cancer
Janina Markowska1, Mariusz Bidziński2, Zbigniew Kojs3, Jan Kotarski4
The paper describes standard therapeutic management used in patients with ovarian cancer, which is based, among other things, on the recommendations of the Polish Gynecological Oncology Society. Therapeutic management encompasses surgical treatment and systemic therapy with cytostatic drugs (typically derivatives of platinum and paclitaxel as first-line therapy). Total or optimal cytoreduction is an important element of surgical treatment. Additionally, the response to first-line adjuvant chemotherapy is a highly significant prognostic factor. Bevacizumab is an effective treatment in the first-line chemotherapy and in patients with platinum-sensitive relapsed ovarian cancer. Trabectedin (Yondelis) used in patients with relapsed ovarian cancer (partially platinum-sensitive) (relapse within 6–12 months after first-line chemotherapy) proved to be an effective drug. Used in combination with pegylated liposomal doxorubicin, the drug significantly improved progressionfree survival (time to progression ranging between 9.2 vs. 7.2 months, p = 0.017) as compared to pegylated liposomal doxorubicin alone. Improvement of overall survival was also demonstrated (22.4 vs. 18.9 months, p = 0.835), however, it was insignificant. In addition, trabectedin used in relapsed ovarian cancer increased sensitivity to platinum and exhibited low toxicity.