演題抄録

基調講演

開催概要
開催回
第53回・2015年・京都
 

Personalization in Gynecologic Cancer Therapeutics: Future Perspective

演題番号 : KL9

[筆頭演者]
Ledermann Jonathan A.:1 

1:UCL Cancer Institute, UK

 

In the last decade the development of molecularly targeted therapy has opened up new avenues for treatment and led to a radical change in therapeutic strategy. Initially, this was focused on targeting angiogenesis, and important factor controlling the growth of ovarian, endometrial and cervical cancers. Different classes of anti-angiogenic drugs have been shown to be active in all these tumours, and in ovarian and cervical cancer the monoclonal antibody bevacizumab has become integrated into the standard of care.
Although much is know about the mechanism of action of anti-angiogenic drugs, it has been difficult to identify predictors of response. In this regard, there has been greater success with PARP inhibitors, a class of drug that inhibits DNA repair. PARP inhibitors are particularly active in patients with BRCA mutated ovarian cancer as a single agent or as maintenance following chemotherapy. Olaparib is the first compound to be licensed but others are now undergoing trials. BRCA mutations predict a response to PARP inhibitors as these tumours have defective DNA repair through homologous recombination deficiency (HRD). This is present in 40-50% of all high-grade serous cancers, opening the way for an expanded use of PARP inhibitors. Recent data suggests that the combining olaparib and the anti-angiogenic drug, cediranib may lead to an additive effect, producing good tumour control without using conventional cytotoxic chemotherapy. Genetic and signalling pathway abnormalities have been found in rarer ovarian tumours, such as low grade, clear cell and small cell cancers, and endometrial cancers, potentially opening new avenues for treatment. However, for ovarian cancer it is now clear that we have already entered a new era of treatment. Conventional cytotoxic therapy continues to have an important role but molecular therapies targeting specific pathway defects are assuming an ever-greater importance

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