Over the past 20 years ovarian cancer has provided a vivid illustration of the successes, failures and challenges for the medical oncologist.
During that time the results of treatment have substantially improved ; in the West of Scotland for example, for women aged under 55,3-year survival rates have increased from 36% to 50%. One reason for this was probably the introduction of effective agents such as cisplatin in the mid-1970s and then carboplatin in the mid-1980s.
The recent introduction of taxoids promises further improvement in the future.
It is important to remember, however, that the best results will be obtained by an optimal organization for the delivery of treatment ; national audit studies have shown that factors such as management in integrated clinics can have a major impact on outcome.
Nevertheless, the majority of patients still die from the disease ; when relapse occurs, clinical drug resistance eventually proves fatal despite further treatment.
What are the fundamental mechanisms by which this resistance develops, and what means are available to attempt its circumvention ?
Factors involved could be described as pharmacological or cellular.
Pharmacological resistance might best be addressed by increasing the doses of the drugs used, particularly, cis-or carboplatin.
Three years ago we published the results of a randomized trial of 2 doses of cisplatin in 191 patients.
At that stage a highly significant median survival advantage for the hig...
Mots-clés Pascal : Cisplatine, Carboplatine, Chimiothérapie, Tumeur maligne, Ovaire, Traitement, Essai clinique, Homme, Article synthèse, Récidive, Résistance, Anticancéreux, Inhibiteur enzyme, DNA topoisomerase, Isomerases, Enzyme, Modèle animal, Lignée cellulaire établie, Platine II Complexe, Ovaire pathologie, Appareil génital femelle pathologie, Epidémiologie, Santé publique, Ecosse, Grande Bretagne, Royaume Uni, Europe, Taxane dérivé
Mots-clés Pascal anglais : Chemotherapy, Malignant tumor, Ovary, Treatment, Clinical trial, Human, Review, Relapse, Resistance, Antineoplastic agent, Enzyme inhibitor, DNA topoisomerase, Isomerases, Enzyme, Animal model, Established cell line, Platinum II Complexes, Ovarian diseases, Female genital diseases, Epidemiology, Scotland, Great Britain, United Kingdom, Europe
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0142820
Code Inist : 002B20C02. Création : 199608.