The majority of patients with ovarian cancer are still diagnosed with advanced stage disease as screening and early detection have not been successful. The cornerstones of therapy have been surgical cytoreduction followed by combination chemotherapy. Numerous clinical trials in the past 4 decades have evaluated various chemotherapeutic approaches and different treatment modalities. Despite this intensive research effort, standard therapy remains surgery and chemotherapy with paclitaxel plus carboplatin. Most patients will achieve a clinical complete remission but over 75% will relapse and recurrent ovarian cancer is not curable. While 5-year survival rates have improved, there has been no significant improvement in overall survival. It is not likely that significant improvements in either surgery or cytotoxic chemotherapy are forthcoming. Molecular targeted therapy is under intensive investigation. However, antiangiogenesis treatment, and PARP inhibiors ( in BRCA patients) have, as yet, only improved progression free survival without an improvement in survival. More specific molecular targets must be identified. Functional genomics, improved pre-clinical models, and a better understanding of the molecular pathogenesis of ovarian cancer perhaps hold the key to novel therapies which will increase the cure rate.
Citation Format: Robert F. Ozols. Ovarian cancer: Time for a new paradigm. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: From Concept to Clinic; Sep 18-21, 2013; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2013;19(19 Suppl):Abstract nr IA12.