Ovarian Cancer - Medications

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Comparative CT Scans. Another method for evaluating the success of chemotherapy is to compare CT scans of the pelvis and abdomen before and after chemotherapy to check the size of any residual tumors that persisted after the original surgery. CT scanning is not always required, however.

Positron Emission Tomography (PET). At present, PET scans have no proven role in the management of patients with ovarian cancer. More study is needed in order to determine their utility in diagnosing relapsed disease.

Investigational Drugs

Patients with any stage of ovarian cancer are candidates for clinical trials. In addition to testing high-dose or combinations of chemotherapy, drugs with unique actions are being investigated.

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HER Dimerization Inihibitors. Pertuzumab (Omnitarg) is the first of a new class of drugs called HER dimerization inhibitors. It is designed to inhibit tumor growth for tumors that express the HER2 receptor protein. Pertuzumab is currently in Phase II trials

Multiple signal transduction regulators (MSTRs). Phenoxodiol is an MSTR that is being developed as a broad-spectrum anti-cancer drug. It is currently being evaluated in Phase II clinical trials, in combination with other drugs such as docetaxel, for its ability to shrink tumors or stop tumor growth in women with ovarian or fallopian cancer who have failed other forms of chemotherapy.

LH-RH Agonists. Luteinizing hormone-releasing hormones (LH-RH) agonists (also called GnRH agonists) include leuprolide (Lupron), goserelin (Zoladex), and deslorelin. These drugs are able to block the release of two major reproductive hormones, and there is some indication that this action may help prevent cell proliferation.

Immunotherapy. Several therapies under investigation use drugs that boost the body's own immune response to specifically attack ovarian cancer cells. To date, they have produced only minor effects. Experimental therapies that are in clinical trials include a vaccinations that use specially designed antibodies (called monoclonal antibodies or MAbs) to boost the immune responses against tumor-associated factors, such as CA125 or HER-2/neu. Vaccines against HERS/neu are also being investigated.

Gene Therapy. Gene therapies generally work in one of two ways:

• One approach involves genes that are used to convert inactive drugs into cancer-fighting drugs.
• The other major approach uses genetic therapies to repair molecular defects that are causing uncontrolled cell proliferation. For example, some investigators are using techniques to deliver a normal p53 gene, which suppresses cancer cell growth, into ovarian cancer cells.

Antiangiogenesis drugs. Angiogenesis, the formation of new blood vessels that feed the growth of a cancerous tumor, is a critical process in the spread of ovarian cancer. Drugs that block this process are under investigation for ovarian cancer. Such drugs include thalidomide, gefinitib (Iressa), and carboxyamido-triazole (CAI).

Aromatase inhibitors. Aromatase inhibitors block aromatase, an enzyme that is a major source of estrogen in many body tissues. The include anastrozole (Arimidex) and letrozole (Femara). A 2002 study suggested they might benefit certain patients who have biologic markers indicating that their cancer cells are sensitive to these drugs.

Retinoids. Laboratory studies have found that retinoids, which are compounds derived from vitamin A, inhibit ovarian cancer cell growth. Certain retinoids, including fenretinide, are being investigated for treating and preventing ovarian cancer.

Epothilones. Epothilones are a new class of anti-cancer drugs that are similar to taxanes (paclitaxel) but are more potent. Currently one of these drugs, called only BMS-247550, is being studied in a late-phase trial for ovarian cancer.

Review Date: 09/01/2006
Reviewed By: Harvey Simon, M.D., Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.

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