Application of ovarian cancer drug resistance

By | April 27, 2012

The application of ovarian cancer, ovarian cancer refers to occurred in the ovarian surface epithelium and its body cavity below the ovarian stromal tumor, is one of common gynecological malignancies. According to preliminary statistics, the incidence rate was 5.37/10 million, ranking No. 3 gynecological malignancies, but its mortality rate continued to hold the first types of gynecologic cancer. The disease can occur at any age, and environmental and endocrine effects of earlier menarche, familial, X-ray irradiation, viral infections (mumps, influenza), chemical carcinogens and excessive intake of animal fat and other factors. 1. Recurrent or persistent ovarian cancer patients with chemotherapy-sensitive groups can be divided into [respond to initial chemotherapy, the tumor-free interval (TFI) 6 months] and chemotherapy-resistant group (disease progression during initial chemotherapy, the best No change or mitigate the size of the lesion TFI <6 months). Chemotherapy-sensitive patients should be platinum-based to give chemotherapy (carboplatin + paclitaxel or gemcitabine). Now that, for patients sensitive to chemotherapy, two drugs together more effective than single drug treatment principles: the initial chemotherapy should be used with the same or similar programs; choose to carboplatin-based outreach program for the second; treatment to disease progress, there can not tolerate the toxicity of clinical complete response or relapse; clinical complete remission and TFI> 6 months in patients with relapse should be applied again after the second joint in the treatment of carboplatin. Sensitive to chemotherapy after relapse or disease progression, re-application of platinum-based chemotherapy, the expected response rate> 60% survival time of 30 months. 2. Chemotherapeutic drug mainly for patients with platinum-resistant and low response rates for other drugs, often associated with neuropathy and bone marrow suppression and other toxic legacy. Such patients should receive single-agent chemotherapy. Now the preferred liposomal doxorubicin (liposomal doxorubicin, PLD), if the disease is still progress can be followed by switching to topotecan, gemcitabine, docetaxel or paclitaxel. Treatment program and its current report response rates as follows: PLD 1 d, remission rate was 19%; topotecan 1.5 mg / (m2 d) 5 d, remission rate was 13%; oral etoposide 50 mg / (m2 d) 21 d, remission rate was 32%; gemcitabine 1000 mg / (m2 w) 3 w, remission rate was 14%. Resistance to chemotherapy in patients with disease recurrence or progression after the application of other medications, the expected response rate of 12% to 32% survival time in 8 months. 3. Since the 20th century began to use the mid-70s cisplatin and carboplatin, widely used in 90 years, platinum has become the treatment of ovarian cancer, the most important drug, but the platinum resistance is also increasingly become an important clinical problem. Clinical models have multiple resistance mechanisms, several hypotheses put forward, the next question is how to link model with clinical drug resistance, new treatments to clear the most relevant sites. The possible mechanism of cisplatin resistance include pharmacokinetic factors (related to drug exposure and tumor blood vessels), micro-environmental factors (and on the cell cycle and extracellular signal-related apoptosis) and cellular factors. At present, most studies have looked at cell factors, but in fact, the joint action of three more important. 4. In addition, phenoxodiol is a small molecule anti-cancer drugs, hormone therapy can be a single drug resistance in prostate cancer is advanced cervical cancer, vaginal cancer and advanced ovarian cancer chemotherapy sensitizer; NOV-002 is based on oxidation of GSH compounds, is the protection of chemotherapy agents and immune modulators have been approved in Russia and the chemotherapy drug combination treatment of ovarian cancer and non-small cell lung cancer. Chemoresistance in ovarian cancer is ovarian cancer recurrence and treatment failure in one of the major.The application of ovarian cancer, how to predict the resistance, how to avoid drug resistance, and how to overcome and reverse the drug resistance is not only a research focus, it will be the future of ovarian cancer in the long-term task.

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