ABSTRACT
During the last decade we have assisted in the development of new therapeutic strategies for the treatment of ovarian cancer, based on the best knowledge of molecular biology. One of the most promising strategies under investigation is antiangiogenic therapy. Bevacizumab is a monoclonal humanised antibody targeting vascular endothelial growth factor (VEGF), which has shown antitumour activity in ovarian cancer in preclinical models as well as in clinical trials, both in monotherapy and in combination with other therapies. Currently, ongoing phase III trials are testing bevacizumab as a front-line therapy with carboplatin and paclitaxel. Bevacizumab has been generally well tolerated with mild frequent toxicities (proteinuria, hypertension and bleeding). However, the drug may result in other uncommon, but potentially life-threatening side effects, such as arterial thromboembolism, wound healing complications, and gastrointestinal perforation or fistulae, which should be considered when the drug is administered. Other new therapeutic antiangiogenic strategies that include small-molecule tyrosine kinase inhibitors, antibodies neutralising the VEGF receptor (VEGFR) and soluble VEGFR hybrids (VEGF Trap) are being investigated with promising early results (AU)
Subject(s)
Humans , Female , Angiogenesis Inhibitors/administration & dosage , Angiogenesis Inhibitors/therapeutic use , Carcinoma/drug therapy , Ovarian Neoplasms/pathology , Carcinoma/pathology , Ovarian Neoplasms/drug therapy , Antibodies, Monoclonal, Humanized , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal/therapeutic use , Carcinoma/blood supply , Chemotherapy, Adjuvant , Algorithms , Neovascularization, Pathologic/drug therapy , Ovarian Neoplasms/blood supply , Recurrence , Dissent and DisputesABSTRACT
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Subject(s)
Humans , Female , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/therapy , Biomarkers, Tumor/analysis , Ovarian Neoplasms/immunology , Ovarian Neoplasms/physiopathologyABSTRACT
National and international specialists have met with the aim of writing down the guidelines for the treatment of epithelial ovarian cancer (in the Spanish Castilian language). These guidelines are based on the International Consensus that was published in English in the Annals of Oncology in 2005. This condition is the leading cause of death from gynaecological cancer in western countries. Its low rate of survival, barely 30% at 5 years, is above all due to late diagnosis and inappropriate surgery, so emphasis is put on these aspects. After describing the methodology for early detection and a scheme of surgical diagnostic procedures in view of the staging of an ovarian mass, the following therapeutic strategies will be recommended: cytoreductive surgery together with platinum chemotherapy under normal conditions, and also in the case of relapse. Likewise, very recent models of treatment focused on molecular targets are presented, and a broad section on methodology of clinical assays. As for this, co-operation among groups is crucial in order to make the conclusions of these studies valid for the development of new therapies.
Subject(s)
Ovarian Neoplasms/therapy , Female , Humans , Neoplasm Recurrence, LocalABSTRACT
National and international specialists have met with the aim of writing down the guidelines for the treatment of epithelial ovarian cancer (in the Spanish Castilian language). These guidelines are based on the International Consensus that was published in English in the Annals of Oncology in 2005. This condition is the leading cause of death from gynaecological cancer in western countries. Its low rate of survival, barely 30% at 5 years, is above all due to late diagnosis and inappropriate surgery, so emphasis is put on these aspects. After describing the methodology for early detection and a scheme of surgical diagnostic procedures in view of the staging of an ovarian mass, the following therapeutic strategies will be recommended: cytoreductive surgery together with platinum chemotherapy under normal conditions, and also in the case of relapse. Likewise, very recent models of treatment focused on molecular targets are presented, and a broad section on methodology of clinical assays. As for this, co-operation among groups is crucial in order to make the conclusions of these studies valid for the development of new therapies (AU)
Subject(s)
Humans , Female , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/therapy , Neoplasm Recurrence, Local/complications , Societies, Medical/legislation & jurisprudence , Societies, Medical/standards , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/therapyABSTRACT
- Propósito: Descripción del patrón característico de disemimación metastática peritoneal del carcinoma lobulillar infiltrante de mama.- Material y métodos: Describimos tres casos de carcinomatosis peritoneal secundaria a la diseminación metastática de carcinoma lobulillar infiltrante de mama. Dos de nuestras pacientes fueron diagnosticadas de carcinomatosis peritoneal como primera manifestación de un carcinoma lobulillar de mama, y la tercera diesiciete años después de su diagnóstico inicial. - Discusión: Las metástasis peritoneales en una paciente con un carcinoma de mama son poco frecuente, pero cuando aparecen suelen ser secundarias a un carcinoma lobulillar infiltrante de mama con receptores hormonales positivos. La inespecificidad de los síntomas junto a un intervalo normalmente largo, incluso de años después de un diagnóstico inicial del tumor, hace difícil diferenciar desde el punto de vista clínico entre un tumor primario de la cavidad peritoneal o la presencia de metástasis de un carcinoma de mama. Este diagnóstico se vuelve aún más complicado cuando la lesión metastática peritoneal es la primera manifestación del cáncer de mama, como ocurrió en dos de nuestras pacientes. Los estudios de inmunohistoquímica pueden ser útiles para lograr un diagnóstico correcto. Los marcadores más informativos son la proteína 15 del flujo de los quistes mamarios (GCDFP-15:gross cystic disease fluid protein-15), y los receptores de estrógeno y progesterona. La identificación de esta entidad es importante para el oncólogo, condiciona el pronóstico y la elección de modalidades terapéuticas adecuadas que difieren a la de otros tumores que también pueden cursar con carcinomatosis peritoneal en su evolución. La quimioterapia y sobre todo la hormonoterapia, tanto los antiestrógenos como los inhibidores de la enzima aromatasa, en tumores con receptores hormonales positivos, puede ser efectiva con remisiones parciales o completas del tumor, que en algunos casos son prolongadas en el tiempo (AU)
Subject(s)
Female , Middle Aged , Humans , Neoplasm Metastasis/pathology , Breast Neoplasms/complications , Peritoneal Neoplasms/secondary , Biopsy , Ascites/pathology , Carcinoma, Ductal, Breast/pathologyABSTRACT
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