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Is ovarian cancer a targetable disease? A systematic review and meta-analysis and genomic data investigation

OBJECTIVES: The current gold-standard for the first-line treatment in IIIb/IV stages of epithelial ovarian cancer (EOC) is the combination of carboplatin and paclitaxel plus bevacizumab in some countries. In the era of personalized medicine, there is still uncertainty on the impact of several molecu...

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Autores principales: Staropoli, Nicoletta, Ciliberto, Domenico, Chiellino, Silvia, Caglioti, Francesca, Del Giudice, Teresa, Gualtieri, Simona, Salvino, Angela, Strangio, Alessandra, Botta, Cirino, Pignata, Sandro, Tassone, Pierfrancesco, Tagliaferri, Pierosandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Impact Journals LLC 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347729/
https://www.ncbi.nlm.nih.gov/pubmed/27764790
http://dx.doi.org/10.18632/oncotarget.12633
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author Staropoli, Nicoletta
Ciliberto, Domenico
Chiellino, Silvia
Caglioti, Francesca
Del Giudice, Teresa
Gualtieri, Simona
Salvino, Angela
Strangio, Alessandra
Botta, Cirino
Pignata, Sandro
Tassone, Pierfrancesco
Tagliaferri, Pierosandro
author_facet Staropoli, Nicoletta
Ciliberto, Domenico
Chiellino, Silvia
Caglioti, Francesca
Del Giudice, Teresa
Gualtieri, Simona
Salvino, Angela
Strangio, Alessandra
Botta, Cirino
Pignata, Sandro
Tassone, Pierfrancesco
Tagliaferri, Pierosandro
author_sort Staropoli, Nicoletta
collection PubMed
description OBJECTIVES: The current gold-standard for the first-line treatment in IIIb/IV stages of epithelial ovarian cancer (EOC) is the combination of carboplatin and paclitaxel plus bevacizumab in some countries. In the era of personalized medicine, there is still uncertainty on the impact of several molecularly targeted agents, which have been investigated for the management of this disease. To shed light on the actual role of targeted therapy in EOC, a systematic review and meta-analysis was performed. METHODS: Clinical trials were selected by searching “Pubmed” database and abstracts from major cancer meetings within the time-frame of January 2004-June 2015. The endpoints were survival outcome and response rate (RR). Hazard ratios (HRs) of survival outcomes, with confidence intervals and odds-ratios (ORs) of RR, were extracted from retrieved studies and used for current analysis. Meta-analysis was carried out by random effect model. RESULTS: 30 randomized trials for a total of 10,530 patients were selected and included in the final analysis. A benefit in terms of OS (pooled HR 0.915; 95%CI 0.840-0.997; p=0.043), particularly for anti-angiogenetic agents (HR 0.872; 95%CI 0.761-1.000; p=0.049), has been demonstrated for targeted therapy. Moreover, a significant advantage in platinum-resistant subgroup in term of PFS (HR 0.755; 95%CI 0.624-0.912; p=0.004) was found. CONCLUSIONS: This systematic review and meta-analysis provide the first evidence that targeted therapy is potentially able to translate into improved survival of EOC patients, with a major role played by anti-angiogenetic drugs. The role of target therapy is underlined in the platinum-resistant setting that represents the “pain in the neck” in EOC management.
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spelling pubmed-53477292017-03-31 Is ovarian cancer a targetable disease? A systematic review and meta-analysis and genomic data investigation Staropoli, Nicoletta Ciliberto, Domenico Chiellino, Silvia Caglioti, Francesca Del Giudice, Teresa Gualtieri, Simona Salvino, Angela Strangio, Alessandra Botta, Cirino Pignata, Sandro Tassone, Pierfrancesco Tagliaferri, Pierosandro Oncotarget Research Paper OBJECTIVES: The current gold-standard for the first-line treatment in IIIb/IV stages of epithelial ovarian cancer (EOC) is the combination of carboplatin and paclitaxel plus bevacizumab in some countries. In the era of personalized medicine, there is still uncertainty on the impact of several molecularly targeted agents, which have been investigated for the management of this disease. To shed light on the actual role of targeted therapy in EOC, a systematic review and meta-analysis was performed. METHODS: Clinical trials were selected by searching “Pubmed” database and abstracts from major cancer meetings within the time-frame of January 2004-June 2015. The endpoints were survival outcome and response rate (RR). Hazard ratios (HRs) of survival outcomes, with confidence intervals and odds-ratios (ORs) of RR, were extracted from retrieved studies and used for current analysis. Meta-analysis was carried out by random effect model. RESULTS: 30 randomized trials for a total of 10,530 patients were selected and included in the final analysis. A benefit in terms of OS (pooled HR 0.915; 95%CI 0.840-0.997; p=0.043), particularly for anti-angiogenetic agents (HR 0.872; 95%CI 0.761-1.000; p=0.049), has been demonstrated for targeted therapy. Moreover, a significant advantage in platinum-resistant subgroup in term of PFS (HR 0.755; 95%CI 0.624-0.912; p=0.004) was found. CONCLUSIONS: This systematic review and meta-analysis provide the first evidence that targeted therapy is potentially able to translate into improved survival of EOC patients, with a major role played by anti-angiogenetic drugs. The role of target therapy is underlined in the platinum-resistant setting that represents the “pain in the neck” in EOC management. Impact Journals LLC 2016-10-13 /pmc/articles/PMC5347729/ /pubmed/27764790 http://dx.doi.org/10.18632/oncotarget.12633 Text en Copyright: © 2016 Staropoli et al. http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Paper
Staropoli, Nicoletta
Ciliberto, Domenico
Chiellino, Silvia
Caglioti, Francesca
Del Giudice, Teresa
Gualtieri, Simona
Salvino, Angela
Strangio, Alessandra
Botta, Cirino
Pignata, Sandro
Tassone, Pierfrancesco
Tagliaferri, Pierosandro
Is ovarian cancer a targetable disease? A systematic review and meta-analysis and genomic data investigation
title Is ovarian cancer a targetable disease? A systematic review and meta-analysis and genomic data investigation
title_full Is ovarian cancer a targetable disease? A systematic review and meta-analysis and genomic data investigation
title_fullStr Is ovarian cancer a targetable disease? A systematic review and meta-analysis and genomic data investigation
title_full_unstemmed Is ovarian cancer a targetable disease? A systematic review and meta-analysis and genomic data investigation
title_short Is ovarian cancer a targetable disease? A systematic review and meta-analysis and genomic data investigation
title_sort is ovarian cancer a targetable disease? a systematic review and meta-analysis and genomic data investigation
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347729/
https://www.ncbi.nlm.nih.gov/pubmed/27764790
http://dx.doi.org/10.18632/oncotarget.12633
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