Cargando…
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...
Autores principales: | , , , , , , , , , , , |
---|---|
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 |
_version_ | 1782514097030430720 |
---|---|
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. |
format | Online Article Text |
id | pubmed-5347729 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Impact Journals LLC |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT staropolinicoletta isovariancanceratargetablediseaseasystematicreviewandmetaanalysisandgenomicdatainvestigation AT cilibertodomenico isovariancanceratargetablediseaseasystematicreviewandmetaanalysisandgenomicdatainvestigation AT chiellinosilvia isovariancanceratargetablediseaseasystematicreviewandmetaanalysisandgenomicdatainvestigation AT cagliotifrancesca isovariancanceratargetablediseaseasystematicreviewandmetaanalysisandgenomicdatainvestigation AT delgiudiceteresa isovariancanceratargetablediseaseasystematicreviewandmetaanalysisandgenomicdatainvestigation AT gualtierisimona isovariancanceratargetablediseaseasystematicreviewandmetaanalysisandgenomicdatainvestigation AT salvinoangela isovariancanceratargetablediseaseasystematicreviewandmetaanalysisandgenomicdatainvestigation AT strangioalessandra isovariancanceratargetablediseaseasystematicreviewandmetaanalysisandgenomicdatainvestigation AT bottacirino isovariancanceratargetablediseaseasystematicreviewandmetaanalysisandgenomicdatainvestigation AT pignatasandro isovariancanceratargetablediseaseasystematicreviewandmetaanalysisandgenomicdatainvestigation AT tassonepierfrancesco isovariancanceratargetablediseaseasystematicreviewandmetaanalysisandgenomicdatainvestigation AT tagliaferripierosandro isovariancanceratargetablediseaseasystematicreviewandmetaanalysisandgenomicdatainvestigation |