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HERO ID
7203597
Reference Type
Journal Article
Title
Epithelial ovarian cancer
Author(s)
Lheureux, S; Gourley, C; Vergote, I; Oza, AM; ,
Year
2019
Is Peer Reviewed?
1
Journal
The Lancet
ISSN:
0140-6736
EISSN:
1474-547X
Publisher
ELSEVIER SCIENCE INC
Location
NEW YORK
Page Numbers
1240-1253
Language
English
PMID
30910306
DOI
10.1016/S0140-6736(18)32552-2
Web of Science Id
WOS:000462038400031
Abstract
Epithelial ovarian cancer generally presents at an advanced stage and is the most common cause of gynaecological cancer death. Treatment requires expert multidisciplinary care. Population-based screening has been ineffective, but new approaches for early diagnosis and prevention that leverage molecular genomics are in development. Initial therapy includes surgery and adjuvant therapy. Epithelial ovarian cancer is composed of distinct histological subtypes with unique genomic characteristics, which are improving the precision and effectiveness of therapy, allowing discovery of predictors of response such as mutations in breast cancer susceptibility genes BRCA1 and BRCA2, and homologous recombination deficiency for DNA damage response pathway inhibitors or resistance (cyclin E1). Rapidly evolving techniques to measure genomic changes in tumour and blood allow for assessment of sensitivity and emergence of resistance to therapy, and might be accurate indicators of residual disease. Recurrence is usually incurable, and patient symptom control and quality of life are key considerations at this stage. Treatments for recurrence have to be designed from a patient's perspective and incorporate meaningful measures of benefit. Urgent progress is needed to develop evidence and consensus-based treatment guidelines for each subgroup, and requires close international cooperation in conducting clinical trials through academic research groups such as the Gynecologic Cancer Intergroup.
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