Anti-angiogenic therapy versus dose-dense paclitaxel therapy for frontline treatment of epithelial ovarian cancer: review of phase III randomized clinical trials.

The investigation of anti-angiogenic agents and dose-dense paclitaxel therapy in epithelial ovarian cancer is an active area of research. To date several phase III trials have shown both approaches to be effective strategies for the frontline treatment of ovarian cancer over standard every 21 day chemotherapy alone. However, most of the improvement is seen only in progression-free survival, with added toxicity (e.g., hypertension, diarrhea, sensory neuropathy, fatigue). Subset analyses based on clinical predictors (e.g., residual disease) have been able to identify patients more likely to benefit from anti-angiogenic agents. And more recently, molecular profiling of tumor genetics has shown similar promising results. Ongoing research will help enhance our ability to match patients to therapeutic strategies most likely to optimize outcomes and minimize risk.