2012 EDUCATIONAL BOOK - American Society of Clinical Oncology

CHEMOTHERAPY FOR OVARIAN CANCER
Fig. 1. Study design of the GOG0262
trial.
Abbreviations: AUC, area under the
curve; PFS, progression-free survival.
mental arms of dose-dense weekly paclitaxel plus triweekly
carboplatin (arm 2) and dose-dense weekly administration of
both paclitaxel and carboplatin (arm 3). They allowed the
use of neoadjuvant chemotherapy as an investigator’s
choice. This trial has just opened in 2011.
Another important unresolved question is the fact that
JGOG3016 failed to show the survival benefit in clear cell
and mucinous cancers. A meta-analysis of breast cancer
trials indicated that the dose-dense strategy only contributed
to prolonging survival in the hormone receptor–negative
patients. 11 The patient population who truly benefit
from the dose-dense strategy must be clarified by future
studies.
In conclusion, dose-dense administration of paclitaxel
showed a substantial improvement in the survival of patients
with ovarian cancer. Further studies ongoing world-
Fig. 2. Study design of MITO-7 trial.
Abbreviations: AUC, area under the
curve; PFS, progression-free survival.
wide and meta-analysis will prove the optimal use of dosedense
strategy in ovarian cancer.
Neoadjuvant Chemotherapy
The general concept of neoadjuvant chemotherapy is to
administer chemotherapy before main treatment such as
surgery or radiation therapy. The purpose of this strategy is
to reduce the tumor size or extent of cancer spread before
applying the radical main treatment, thus making the
procedure easier or less invasive. It also provides the chance
to know whether the chemotherapy is effective, which is not
possible when the tumor is completely removed.
Neoadjuvant chemotherapy has been studied in several
types of cancer, such as breast, prostate, cervix, colorectal,
lung, and esophageal cancers. Among them, breast, prostate,
and cervical cancers have been investigated more
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